HomeMy WebLinkAboutCLE201100060 Review Comments Zoning Clearance 2011-04-2903/18/2011 FRI 12:10 FAX 434 978 1667
001/003��
- ..__ .................. --- -
Application for Zoning ClearanceyL�`rm
�l ` U U
CLE # ;?
OFFICE US ON X
l
PLEASE REVIEW ALL 3 SHEETS
Check 9 Date:
Receipt # Staff. rYi�}Q1y
—
PARCEL INFORMATION
Tax Map and Parcel: 07800 -00 -00 -05500 Existing Zoning x'MIC
Parcel'Owner: Luxor Of fi re Park, T T C
ParcetAddress: 1434 Rolkin CT. Suite 201 City Cha.rlottesvilleState ETA Z11)22911
(immciude suite or floor)
PRIMARY CONTACT
Who should we call /write cancerninb this project? PL -'1"C iZ ? . O-14) aD
Address : 12 34 R•ojAe =, gT 5�,' -e 2-o l_ City tJ /P Zip ZZ9' I j
O!'Gce Phone: (� �L � ' D j� Cc11 tt y �, t� �) �9 �•aa #•� }'�� ���I66�� -snail
APPLICANT INFORMATION
Check any that apply: Cltange of ownership Change of use Change of name New business
Business N.ILIMe /Type: l�ril--0-rL S . ilow a2 At LI>
Previous Business on this site Not ap- lis &blg _ �T,, eamastxurot isn
Mscribe the proposed business including use, number or employees, number of shifts, available parking spaces, number of
ve.hirles, and any additiomtal irm!'ormafiomt that you can provide; Mis 01 eA! oFGY Gt?
"This Clearance will only be valid on the parcel lbr which it is approved. If you change, intensify or move the use ID a new location, a new Zoping
Clearance will be required.
1 herebycertify that 1 own or have the owner's pennission to use the space indicated on this application- 1 also certify that the information provided
is true and accurate best of my-;h ledge. I have read the conditions of approval, and 1 understand them, and that I will abide by them,
Signature j/ ` Printed °�G �i ~� j _ 1�, pL•J .�� L_
APPROVAL INFORM: T.ION
[ j Approved as proposed [ ] Approved with conditions [ ] Denied
[ ) Baektlow 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 detdrtninatiort of compliance with the existing
site plan.
[ ] This site complies with the site plan as of this date,
)Votes:
Building Official Date
Zoning Official D•a.te'/
Other Official Date.
County of Albemarle Department of Community Development
401 Mclntire.I2oad CJmarlottesvil1c, VA 22902 Voice: (434) 2 .96 -5832 'Fax: (434) 972 -4126
Revised 1/1/2011 Page 2 o.f3
All
II
03/18/2011 FRI 12:11 FAX 434 978 1667
002/003
Intake to complete the following:
Reviewer to complete the following:
Y J�
Square footage of Use: V
Is us m LI,'H1 or PDIP zoning'? If so, give applicant. Certified
fsngincer's Report (CER) packet.
J
Qn,litted N
as: V d 1r
Nc
!�
I�
Will re be food preparation?
Under Section: (J6) 1
If so,-give applicant a Health Department form.
Zoning review can not begin until we receive approval from Health
Supplementary regulations section:
Dept. FA'X 'DATE
r--�►-
Cleal•ances:
Circle the one that applies
Parking formula:
Is parcel on private well o ublic
If private well, provide I- lealth Department form.
Zoning review can not begin until we receive approval from I-Icaltlt
Required spaces:
Dept. • FAX DATE
1„J
Y /Nr
Circle; the one that applies
Items to be veri ed in the field:
Is parcel on septic or ll is sewer
Y /(5)
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
inspector : Date:
/ N
Notes;
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Per►nit# 2011- 00070AC
Zoning to conlivlete the following:
�Vio k' ns: —
Ifs il;r
r Fers:
List:
Ya i'a'tt•ce:
Y f N�
's:
N
so, List:
Cleal•ances:
�A 14 -
03/18/2011 FRI 12!11 FAX 434 978 1667
EXHIBIT.B
LUXOR OFFICE PARK -
SCHEMATIC OF SUITE 1434-201
003/003