HomeMy WebLinkAboutCLE201000223 Review Comments Zoning Clearance 2010-11-03M
C earance
Application forte:
/Zon
CLE #
b�NatN�n
] Zoning Clearance = S35
PL- AYS IZ VIE�4' ALL 3 SHEETS
OFFICE USE ONLY
Check # + Date: _
Receipt # Staff':
PARCEL INFORMATION
Tax Map and Parcel;7�17(�- "d(�'�� `OJi �� ��� Existing Zoning
Parcel Owner: Iq LTV S 1 /,S Ito Z50 L L C—
p
Parcel Address: q4 L7 PpLk!I(l C! City Chj-'�t fft- Q)_11 4tate //� ZipL2`� %�
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? M111e
Address: 2-KO(? T17,.h'11v C/evl+' L�ll uPCitl' /_ /[ J l�j State Zip
Office Phone; ` /(�5►_ % yGv Cell # ��` �n �� Fax # -703-- -0: E-mail
3 q2 LI Z( g `ri
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of ]name New business
Business Name /Type: bi AC�QUO /' tUe- -LL i
Previous Business on this site IMi E
Describe the proposed business including use, number of employees number of shifts, available parking spaces, number f
vehicles, and any additional information that you can provide: e"71.7 &-ee L 'n ✓� t
/' t'
*This Clearance.wiil only be valid on the parcel for which it is approved. If you change, intensify or move the use to a new location, a new Zoning
Clearance will be required.
I hereby certify that I own or have the owner's permission to use the space indicated on this application. I also certify that the information provided
is true and accurate to the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed_ (, !i?�%/r �Ir %� . S � �Q'y
APPROVAL INFORIlZATION
Approved as proposed [ ]Approved with conditions [ ]Denied
[ ] Backflow prevention device and/or current test data needed for this site, Contact ACSA, 977 -4511, xl 17.
[ ] No physical site inspection has been done for this clearance. Therefore, it is not a detennination of compliance with the existing
site plan.
[ ] This site complies with the site plan as of this date.
Notes:
`�— Date
Building Official �'
Zoning Official Date
Other Official Date
Count, of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax. (434) 972 -4126
Revised 04/28/08, 10/13/09 Page 2 of 3
Intake to complete the following:
Y / 1\1
Isu0111,111-Iloi-PI)IJ'zoning? if so, give applicant a Certified
Engineer's Report (CER) packer.
'MQe be food preparation?
If so, give applicant 8 Health Department fon-n.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applies
Is parcel on private well r public wa 0
artment form.
If private well, provide H �52
Zoning review can not begin until we receive approval from Health
Dept, FAX DATE
Circle the one that 4� � le
Is parcel on septic
c sewer?
N
\7ill you be putting up a new sign of any kind? If so, obtain proper
Sign Permit.
Permit
�/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit # 0 �7—
Reviewer to complete the following:
Square footage of Use: Nob
/ N
rmittrd as: 'k--
A
Under Section: t--5 M. I
Supplementary regulations section:
Parking formula:
Required spaces:
Y/
ItenV,t6be verified in the field:
Inspector : Date:
Notes:
Zoning to complete the foll Om4ng: offers:
vl,llations:
(Y 9N.
Y If -so, List:
If s&rtist:
Nlarw'Ace: SP
Y ION Y
If so, List: If so, List:
Clearances: SDP's
Revised 04/28/08, 10/13/09 Page 3 of 3