HomeMy WebLinkAboutCLE201100103 Review Comments Zoning Clearance 2011-06-08he f.
Application for Zonzn Clearance ��o�• �¢
rinra�
OFFICE WILY
PLEASE REVIEW ALL 3 SE EL,TS Qaeelc # Date:
Receipt # Mclb Staff;
PARCEL W' ORMAT O T y�
Tax Map and Parcel: _ v Existing Zoning / p/ U
Parcel Owner: VOA ow
Parcel Address: 1691 ri City r State Zip
(include suite or floor)
PRDNIARY CONTACT
Who should ' wa tali /write concerning this project? ��, ew� / � S A
� it
Address 5-& i fno L 11 City St ate V
a . Zip 2
Office phone: ((0) S�"7'G82 Cell # Fax # E -mail
APPLICANT INFORIIZ.ATION
Cheek any that apply: Change of ownership Change of use Change of name New business
Business Nnme/I`ype: _VIV�.�f Val ,'t%/dri
Previous Business on this site CATO g l awe
Describe the proposed business including use, number of employees, number of shifts, /a�vailableparldng s aces, number of
vehicles, and any additional information that you can provide: F00 d 2 Gw►/Ily elc '7 A T
*ibis Clearance will only be valid on the parcel for which it is approved. Ifyou change, intensify or move the use to a new location, anew Zoning
Clearance will be required.
I hereby certify that I own or have the owners permission to use the space indicated on this application. I also certify that the information provided
is true and accura to the best ofmy knowledge, I have read the conditions of approval, and I understand them, and that I will abide by there.
Sigrtature � Printed �/'ra4 t�l/bt ,�� 41n
J—
APPROVAL INFORMATION
Approved as proposed [ ] Approved with conditions. [ ] Denied
] BaoUow 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.
f ) This site complies with the site plan as of this date.
Notes:
Building Official �~ �,�fp• C'
.7
Zoning Official
Other Official Aare
County of Albemarle Department of Community Development
401 McIntire Rood Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 1/1 /2011 Page 2 of 3
Intalce to complete the following:
Y /0
Is use in LI, HI orPDIP Zoning? Ifso, give appiicant a Certified
Engineees Report (CLLR) packet.
Y/N
Will there be food preparation?
If so, give applicant a Health Department form.
Zoning review can not be in un 11 we receive approval from Health
Dept. FAX DATE
Circle the one that applies
Is parcel on private well o u iie w r?
If private well, provide Heat a arnnent form.
Zoning review can not begin until we receive approval from Health
Dept, FAX DATE
Circle the one that applies--
Is parcel on septic or u lie se�v ?
Reviewer to complete the following:
Square footage of Use: 6o
Permitted as: e..,44; A4 41s4�;�✓�
Under Section: s L-
, 1
Supplementary regulations section:
Parking formula: -P -PSG�
Required spaces:
Y/N
Items to be verified in the field:
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit # Inspector ; Date:
Y / N Notes;
Will there be any now construction or renovations?
If so, obtain the proper Permit.
Permit #
Zenin¢ to complete the foIlowinpr:
Violations:
6)/ N
so, List:
Proffers:
Y /
If so, ist:
Variance;
Y/
If so, ist:
Y /(M)
If so,eist:
Clearances:
SDP's
Revised 1/1 /2011 Page 3 of