HomeMy WebLinkAboutCLE201000230 Review Comments Zoning Clearance 2010-11-09Application for Zonin - Clearance
CLE # 510 /0
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Clearance = $35
OFFICE USE NLY
Check # Date:
Receipt # Staff:
PLEAZoning
REVIEW ALL 3 SHEETS
PARCEL INFORMATION
'h 0 ` I Z -6I 01 Existing Zoning
Tax Map and Parcel: J
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G
P•arcelOwner: UV/
Parcel Address: �VUIt� GJtJ'�ld� G �S I�C State_ Zip�u
(include suite or floor)
PRIMARY CONTACT hap-
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Who should we c� all /write concerning ttliproectt?
S� S�ta�te V�A
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Address :
Office Phone: ��� ���%CeII# q, Fax #_ 3ZS IS�7 E -mail �� �[�1Kam` -'10-e
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
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��'�'���.I y � Y � � � � � U PIC..� G�
Business Name /Type:
Previous Business on this site N
Describe the proposed business including use, number of employees, number of shifts, available parkin spaces, number of
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v hicles, and any additional in ormatio that you can provide:
*This Clearance will only be valid on the parcel for which it is approved. If you change, intensify or move the use to a new location; anew Zoning
Clearance will be required.
I hereby c Ai- }f lh t 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 an accurat� the best of fly knowledge I have read a conditions of approval, I understand them, and that I will abide by them.
Signature '�4'dkaH�A Printed le, VA
APPROVA FORMATION
Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Backflow prevention device and/or current 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 determination of compliance with the existing
site plan.
[ ] This site complies with the site plan as of this date.
Notes:
Building Official Date l ( o
Zoning Official Date 11l�S/y
Other Official 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 followiDg
Reviewer to complete the following:
N
Y " a
Square footage of Use:
Is1HlorPDIPzoning9 Ifso, give applicant a Certified
Engineer's Report (CER) packet.
N
'Permitted as: i'�A
e food preparation?
Under Section:
Ifso; give applicant -a-Health Department =form.
-
Zoning ng review can not begin until We receive approval from Health
Supplementary regulations section:
Dept, FAX DATE
Variance:
Y
If so,
Circle the one that applies
Parking formula:
is parcel on private well or P ic water?
P ?
r �Tn
e
If private well, provide FiSa I �Ment form.
Zoning review can not begin until We receive approval from Health
Required spaces:
Dept. FAX DATE
-
F"
,/6)7
Circle the one that applies
terns to be verified in the field:
Is parcel on septic or p:u �c sewer?
Y
Will eyoe putting up a new sign of any Icind? Ifso, obtain proper
Sign permit.
Inspector Date:
Permit 4
Y
Notes:
Will ere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
2,0111-Ug LU CUU1-21r-Lr
Violations:
Y/0
If so, List:
L-LIC; -Lu-tiv Ty J.Llr,-
Pro s,
Y
Ifs , &—L-'1st:
Variance:
Y
If so,
SP's-
Y/W
If so, List:
Clearances:
SDP's
Revised 04/28/08, 10/13/09 Page 3 of 3
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