HomeMy WebLinkAboutCLE201100102 Review Comments Zoning Clearance 2011-06-06i
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MORGANSTANLEYSMITHBA
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Application for Zonl, g clearance
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CLE # 2611-1 02
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FFICE USE ONLY G
PLEASE REVIEW ALL 3 SHEETS Oeck # �-�� Date: 5
Receipt # r l Stems, (Y� ipi
PARCEL INFORMATION
Tax Map and Parcel. 7q -- Existing Zonin
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Parcel Owner-
Parcel Address: City State Zi
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PRIMARY CONTACT
Who should we caaWwNriitee concerning this project?
Address i ) (1 i i►1' Yl� �%��� ,� City State ,1
Office Phone: ( Cell # W/ 76 Fart #
E -mail
APPLICANT INFORMATION
Check any that apply, Change of ownership X ch' ange of use Change of name New business
Business Name/Type:
Previous Business on this site i
Describe the proposed business including use, number of emplo lees, n Huber of shifts, a enable pa spaces, n m r of
ve cles, and any ad na( fo�mation at u can pr vi
O'n t" fO
*'Phis Clearance will fahly K valid on th ' arcel for w 'ch it is approved. 1f you change, intensify or move the use to a new location., a now 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 acs a to the best of my (rnow e. I hav a cc 'done I of approv and I understand them, and that Twill abide by them.
Signature Pt�inted Avls�
APPROVAL INFORMATION
Approved as proposed [ ) Approved with onditaons [ ] Denied
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[ ) 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: j
Building Olfftci2l Jute C- �% t
Zoning Official I Date
Other Official Date
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t-ounry o[ eunemarte mepartment of community Development .
401 McIntire Road Charlottesville, VA 22912 Voice: (434) 296-5832 )Fax: (434) 9724176
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Intake to complete the following- RMewer to complete the follovdng:
Y (, Square footage of Use;
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet / N
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Oernntted as:
Y /,"N'
be food preparation? Under Section:
If so, give applicant a Health Department form
Zoning review can not begin until we receive approval from Health Supplementary regulations section:
Dept. FAX DATE
Circle the one tbat..applies Parking formula:
Is parcel on Pi xate� ,'Fell or public water?
If private well, provide Health Department form.
Zoning review can not begin until we receive approval from Health Required spaces-
Dept. FAX DA'Z'E `
Y
Circle the one that applies I Itet�s to be verified in the field:
Is parcel on etic p r public sewer?
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit # Inspector
Y / N Notes;
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
zonin7 to complete the following:
Date:
Violations:
Y /fi�
If so, List:
!P roff
iY /N
If s05 ist:
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Varian e:
Y /(l /
If so, List:
SPIN-
W1 N
i If so, List:
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Clearances:
ISDP's
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