HomeMy WebLinkAboutCLE201100113 Review Comments Zoning Clearance 2011-06-08Application Zoning Clearance
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CLE # 2-011-115
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PLEASE kEVIEW ALL 3 SHEL TS
Receipt# Staff:
PARCEL INFORMATION ann- cd 1, -eu'ela'Oyjlwrj -
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Tax Map and Parcel: 0, -4 K()() ° l�l.) - nc) •-- O'S 1 Existing Zoning 1Y1 lk -t' "1 Lomri rC:ki
Parcel Owner: 1> > l ll �(I((6
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Parcel Address: u '75 �c)ic)( ,1 '(- L 1 City ; t" (64f i State VA Zip 77' M
(include suite or floor) `k-12 2-C1 D
PRIMARY CONTACT
Who /write this ' S ✓'�
should we call concerning project. t t_,p,
Addres s:g45 PPS O J p fX,ti1 ity_ ++., t� Wo State Zip
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Office Phone: �2� 'Z Cell # 20 l., 06 Fax # (.t' -0 07 _ E -mail � t r r 1
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name business
Business Name /Type: r-. ``New
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Previous Business on this site
Describe the proposed business including use, number of employees, number of shifts, av`aailabl parking spaces, number of
information
vehicles, and any additional that you can provide: 2 r
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*This Clearance ivill_onl, 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 bq1owi
1 hereby certify tr have t e owne r s pert ission to use the space indicated on this application. I also certify that the information provided
is true and accur st of my o have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed S a r
APPROVAL INFORMATION
Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Backt1ow 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
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Zoning Official / Date
N
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
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Intake to complete the following:
Y /cl� )
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y //N
Will ere 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 r public water?_--)
If private well, provide Heat epai finent form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that ap l'e __ -- --
Is parcel on septic 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 #
Zoning to complete the following:
Reviewer to complete the following:
Square footage of Use: q S",
6 / N 0
Permitted as: �' f } O 't
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Under Section: "Z
Supplementary regulations section:
Parking formula:
Required spaces:
Y/
ItemSTO be verified in the field:
Inspector: - Date:
Notes:
Violat'ons:
If /%N�
If so, rst:
�R offers:
N
ITso, List:
Vari' ce:
Y/M
If so,-List:
SP's-
Y
If so, gist:
Clearances:
SDP's_____ —
Revised 1/1/2011 Page 3 of 3
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EXHIBIT A
LOCATION PLAN (NOT TO SCALE)
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N
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