HomeMy WebLinkAboutCLE201000224 Review Comments Zoning Clearance 2010-11-08Application for io Clearance
CLE Z -
OFFICE USE� O� N1'
PLEAZoning Clearance = S35 Check # / Date:
REVIEW ALL 3 SHEETS Receipt # Staff:
PARCEL INFORMATIONr. j _ I
Tax Map and Parcel: (��%}� Existing Zoning JQL✓i+� C�i2oZ�
Parcel Owner: OL- F -774 MQ&- XY0 ipFS
2 9�
Parcel Address; City l"ea> r r State IM _ZIP
(include suite or floor)
PRIMARY CONTACT �� 1 `�1�4— V' , ��
V41ho should we call /write concerning this project, .
Address: V Vl wt'w City Q H 1i'LUT1d 0 a Late �} . Zip
Office Phone; ( 96 y_t 7$�c Cell # Fax # E -mail Jyp irlkVAg,14-C
C6'vh
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name Nevi' business
Business Name /Type: lk& r I G /ivy t
Previous Business on this site
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
vehicles, and any additional information that you can provide:
*This Clearance will on)), 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 spaceindicated on this application. I also certify that the information provided
is true an curate to the bes �fmknowled rave read the conditions of approval, and I understand themn, and that I will abide by them.
Si> natur
Printed �V l) 1 rx!4- V �"kmC7 lJ%2 C t4"
APP VAL INFOR: -AYION
�proved as proposed ✓✓ [ ] Approved with conditions [ ]Denied
l J ackflow prevention device and/or cutTent test data needed for this site. Contact ACSA, 977 -4511, x117.
[ ] No physical site inspection has been done for this clearance, Therefore, it is not a detenrrination of compliance with the existing
site plan.
[ ] This site complies with the site plan as of this date.
Notes:
Building Official
Zoning Official
Other Official
Date j ( 3 ((.0
Date 64 J1
Date
County 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 I,
is u � L1, HI or PDIP zoning? if so, give applicant a Certified
Engineer's Reporl (CER) packet.
�' (3
Wi Wre be food preparation?
If so, give applicant a Health Department for 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 or lic , ter?
If private well, provide He epartment fonn.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that-applies
b
Reviewer to complete the following:
Square footage of Use: t)
�/ 19
Permitted as: r P_t`R
Under Section: yO
`? a2— A I
Supplementary regulations section:
Parking formula:
Required spaces: %
I e verificd in the field:
Is parcel on septic or pu
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign Permit. Inspector : Date:
Permit #
Notes:
Y/N
,Ali]] there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning to complete the Lobo wing:
Violations;
Y W. �'
If so, List:
Prof,":
Y/N _
If so, List:
Vari nce:
1' // V�
If so, ist:
SP's:
0/ N
If so, List:
Clearances:
D .5
SDP's
�n
Revised 04/28/08, 10/13/09 Page 3 of 3