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HomeMy WebLinkAboutCLE201100031 Review Comments Zoning Clearance 2011-02-09Application for Zoning Clearance = "F "�`r CLE # DWI 3/ l�" OFFICE USE 0 y Check # Date: G PLEASE REVIEW ALL 3 SHEETS rS Receipt # / Staff: PARCEL INFORMATION 1 ,hj to Tax Map and Parcel: Existing Zoning �Ll� Parcel owner: KC—MMAMAl9P/N '- MICRACL //I,/ �/M/h/P Parcel Address: q 2SG .r1ZC—G I�/i//b/� RD city FKC- GUNIVA State VI2G /%V /19 Zip����� (include suite or floor) PRIMARY CONTACT ,, Who should we call /write concerning this project? A-1 104A Q: L M ,A (IN IV �28�6 �'aG 01V10n/ �RD, city f=��l: UlIofV stateVIIZ6II1 /p Zip Address: y 1 Office Phone: ( 3q) 973 —39 0 well # Fax # i' E -mail APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business Name /Type: �� P i7 L P, C O C) A/ 12� Previous Business on this site 11 �� /y 2 ©rl -IG�S zc ( V mi2r D2 Describe the proposed business including use, number of employees, number of shifts, available arking spaces, number of O vehicles, and any additional information that you can provide: C�/11�T R -s % ©f�.�►�I����5,: 2� PA1ZK11V6 -9PA CF9' G AS PL) M P r *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 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 %ntt��s_(2JC L9/ Printed M104A IG C VV,MAOPJIV APPROVAL INFORMATION as proposed [ ] Approved with conditions [ ] Denied ']Approved 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 ' r Date Zoning Official Date 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 1/1/2011 Page 2 of 3 Intake to complete the following: Y/N Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y wiptiere be food preparation? -If so, give applicant a Health Department form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the i �'t Is parcel oor public water? If private , ealth Department form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applies Is parcel on EF>r public sewer? Y. NZ. Will you be putting up a new sign of any kind? If so, obtain proper Sign- permit. i fefiiiit # Y % W ill there be any new construction or renovations? If so, obtain the proper Permit. Permit # 7nning to comnlete the following: Reviewer to complete the following: Square footage of Use: 41'0 L') b /N as: Under Section: Supplementary regulations section: Parking formula: Required spaces: Y/N Items to be verified in the field: Inspector : Date: Notes: J eJ (k n In) t+1°Y. � Violations: Y/N If so, List: Proffers: Y/N If so, List: r •� ii Variance: {Y /.N i! If.s6, List: i SP's: Y/N If so, List: Clearances: SDP's Revised 1/1/2011 Page 3 of 3 LJ 41% 10