HomeMy WebLinkAboutCLE201100077 Review Comments Zoning Clearance 2011-05-04Application for Zoning Clearance_"
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PLEASE REVIEW ALL 3 SHEETS
Cheelc w Date;
Receipt# fD Staff;
PARCEL INFO T O p�� �y
�D " j 'V(J `'{� `Q� ExlstiagZoning_..D% e'mW[�il l�[.
Tax Map and Parcel; .
Parcel Owner., �J�'"�nr� S C>�— Cove,- LCA.- n . Li-,C-
Parcel Address: F CAI-e City 0 a/1 V(j V State V � ziT; 1
(Include suite or floor) 5t44-e a
PRIMARY CONTACT ' ��� ��
Who should we call /write concerning this project.
Address; 2 l g - 5zAdle Hd Joy OJ City Coze-1 State 1rl Zip
Office Phone; Celt *4,% ' !Mc), iii. # E -mail vn&�.!Gn)k @ qrr)ai
APPLICANT INFORMATION
Cheek any that apply: Change of ownership Change of use —Change of name New business
Business Name/Type; Euq . LL-(— S I 2�
Previous Business on this site C J= S
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 newZoning
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 ofmy knowledge. I have read the conditions of approval, and I them, and that I will abide by them.
understand
Signatur R Printed 40en fCr'1
APPROVAL INFORMATION
[ j Approved as proposed [ j Approved with conditions [ ])Denied
Baokflow prevention device and /or current test data needed for this site. Contact ACSA, 977 -4511, x117,
[ j 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,
Dotes;
Building Official Date
Zoning Official Date
Other Official LL�ON Date '519111
County of Albemarle Department of Community Development
401 MclntireRond CharIottesAlle,YA22902'Voice., (434) 296- 5832Fax; (434) 972 -4126
Revised 1/1/2011 Page 2 of 3
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Intake to complete the following:
Y %�
Is use in LI, HI orPDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
r / N
ll there 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 one that applies
Is parcel on private well or u�eppaartpment r?
If private well, provide Healt form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that appli
Is parcel on septic or er?
Y
Wil you be puffing up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y /N3,
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning to complete the f0Ilo)vi.n6:
Reviewer to complete the following:
Square footage of Use:
OerN
mitted as:
Under Section:
Supplementary regulations section:
Parking formula:
Required spaces:
YIN
Items to be verified in the field:
Inspector : Date: 33
Notes: V 0A)
Violations:
Y i Z
If so, List:
Proffers:
'Y /A
If soyist:
Variance:
Y/F
If so, List:
SP's:
Y/ r
If so, List:
Clearances: r ---'"
SDP's
Revised 1/1/2011 Page 3 of 3