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Home My WebLink AboutCLE201100093 Review Comments Zoning Clearance 2011-05-13Applicati ®n f ®r Zon/i�ng Clearance 0 PLEASE REVIEW ALL 3 SHEETS OFFICE USE NLY Check # / Sy Date: 15'' Receipt # Staff: PARCEL INFORMATION Tax Map and Parcel: j blioO -oc) •- 00 [H pc, Existing Zoning Parcel Owner: —Se." (-c\A -te-4 Parcel Address: 3°13 Rgk \, hu R A City SUi �'� State L} di Zip ausw (include suite or flo r) PRIMARY CONTACT Pei1n r—r--15 Who should we call /write concerning this project? - i Address: u-kga Pecs«Aer)�5 R(A City State U A Zip ays-ceb Office Phone: 6 )q 5 -3loa Cell #'13452)2-)319 Fax # 4,34 -Q@0 - 31UX-mail 5%tX(Aq A 6 ►.>✓ APPLICANT INFORMATION Check any that apply: ' Change of ownership Change of use ✓ Change of name New business Business Name/Type: (e Q. 0 5�e - IV •- tso l Agj '<-e�r en ce- . S pre Previous Business on this site c+..c) oe_r) j erne � e 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: ct em.65 a , T.r� �cp i0, *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 Printed APPROVAL INFORMATION [ ] Approved as proposed Jo� 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 i 1 Zoning Official Date S Other Official Date Wd 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 :a r Intake to complete the following: Y/aIs us LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. (2'Nthere 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 t s Is parcel on rivate well )r public water? If private we e ealth Department form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the on "applies Is parcel on eptic r public sewer? Y/N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Y/N Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # 7nninv to emmrilPtP the fnllnwinv- Reviewer to complete the following: Square footage of Use: 0/N Permitted as:"% Under Section: % b Supplementary regulations section: Parking formula: Required spaces: Y/N Items to be verified in the field: Inspector : Date: Notes: Violations: Y /( ' _ If so ist: Proffers: Y / -(R If so,itist: Vari ce: If // I s f o, is t: SP's: I so st: Yt� Clearances: SDP's --� Revised 1/1/2011 Page 3 of 3 VIRGINIA DEPARTMENT V'DHOF HEALTH Protecting You and Your Environment Albemarle County Health Department PO Box 7546 Charlottesville, VA 22906 (434) 972 -6219 Voice (434) 972 -4310 Fax Sewage Disposal System Operation Permit Property Owner Health Dept. ID: 101 -11 -0206 Catlett, Jeff - Rolling Road Country Store, LLC Tax Map: 104 -14H 1140 East Market Stret #202 Charlottesville, VA 22902 Locality: Albemarle Phone: (434) 960 -0276 PropertV Location Property Address: 3937 Rolling Road Charlottesville, VA Directions: East side on Rt. 620, approx. 1.65 miles North of t. 620 /Rt. 728 intersection. Catlett, Jeff - Rolling Road Country Store, LLC is hereby granted permission to operate a Septic Tank Only and Aggregate Trench Sewage System at the above referenced location, having a design capacity of 300 gallons per day maximum. This permit is issued in accordance with the provisions of Title 32.1, Chapter 6 of the Code of Virginia as Amended, and Section 12VAC 5- 610 -340 of the Sewage Handling and Disposal Regulations of the Virginia Department of Health. The issuance of an operation permit does not denote or imply any guarantee by the department that the sewage disposal system will function for any specified period of time. It shall be the responsibility of the owner or any subsequent owner to maintain, repair, or replace any sewage disposal system that ceases to operate in accordance with the regulations. June 30, 2011 Effective Date Josh Kirtley EHS .�. ' Copy For: Albemarle Building Inspections Albemarle County Office Building APPROVE11 401 McIntire Road Charlottesville, VA 22902 I