HomeMy WebLinkAboutCLE201000240 Review Comments Zoning Clearance 2010-11-19Application f ®r ZoninLy Clearance
CLE # .
I/RGIN�P
_ ----- - - -_._ ._.----- - - - - -- ..._- - - - - -- -----------
Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
OFFICE-USE-ON -Y---------------9----------------
Check # Uc Date:
Receipt # 7 Staff:
PARCEL- INFORnkTIOly /— /� - - -- - _ _ __ _ _ - -- - - - - --
Tax Map and Parcel: 6/ —' Z,3Z 7T1 Existing Zoning iDD S
/
Parcel Owner:_ sMal�/ /'�a.��y 0 (/b tr /ocr�
Parcel Address: 2z & J J 2 City 664y 4/State 11-4 zip ?2 I
(include suite or floor)
PRIMARY CONTACT G `,
Who should we call /write concerning this project?
Address : ��� � � � ? City tJ a State 1y Zip
Office Phone: !S'L\ Cell # Z>� Fax # E -mail koalf 6yttQ t mtikU_ car
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name /Type:
7
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 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 rtify that I own r have the owner's permission to use the space indicated on this application. I also certify that the infonnation provided
is rue an a ur to th of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
ignature Printed
APPROVAL INFORMA'AQN
Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Bacicflow 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 to (t t
Zoning Official Date
Other Official Date
County of Albemarle Department of community l)evelopment
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
-1 EL
6 olations:
/N
'If so, List:
k4j
Intake to complete the following:
Reviewer to complete the following:
Y )r
/
Square footage of Use:
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
E ngineer's Report (CER) packet.
/ N rrnitted_as: -_. -_L lIV ii�ll m —
Oe
SP's:
Y/
If so, List:
- --
� • 1 there be food preparation?
If so, give applicant a Health D ailment form. -
Zoning- review-can-not-begi ntiI-we- receive approval from Health
Under Section: I,;', >i
-
Supplementary- regulations section: - - - -
- --
Dept. FAX DATE
Clearances:
k/
SDP's
Circle the one that applie
Is parcel on private well public w r?
Parking formula: P�S�
Required spaces:
If private well, provide meat form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Y/
Circle the one that applies
Item o be verified in the field:
Is parcel on septic • public er?
Y /V
Will you be putting up a new sign of any ]rind? If so, obtain proper
Sign permit.
Permit #
Inspector : Date:
Y / N
Notes:
Will there be any new construction or renovations?
If so, obtain the proper Permit. )
Permit#
-1 EL
6 olations:
/N
'If so, List:
k4j
Prof rs:
Y/
If so, List:
Vari nce:
Y/
If s , ist:
SP's:
Y/
If so, List:
Clearances:
k/
SDP's
Revised 04/28/08, 10/13/09 Page 3 of 3