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HomeMy WebLinkAboutCLE201100120 Review Comments Zoning Clearance 2011-06-24l Application for Zoning Clearance CLE N OFFICE USE O Y 12 0 `21 ` ( 1 PLEASE REVIEW ALL 3 SHEETS Check # Date: Receipt # Staff: YYyW,_,, PARCEL INFORMATIO f � ar � Tax Map and Parcel: Existing Zoning Parcel Owner: W sc C it enl-j . ram, rJ V 10X1 t 7 4��� 160 n Parcel Address: �J Q ����P � (( T "* City 6_[e �v j(��U� ([ f State Zip22`r 1 (include suite or floor) PRIMARY CONTACT �y,� ©cr')`u� "/ Iv ec-i< Who should we call /write concerning this project? l 1 Address: (�C) PE.I 23eje-FFLe5dA) Pk- City CU49LC+<<C ViL4.9_tate (/ Iq Zip A91 Office Phone: Cell # Fax # UU44 A -mail i'C9S mo fu a 1+ e_l U APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business Name /Type: r. —iZAZ. l /=K [ FOR t./- a'e'�j J 0Q /' ,fin I D PLC— Previous Business on this site Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of informs 'on full =OtCA L P,� 8CTICOK % 1n04/rJ�/ 27W, vehicles, and any additional that you can provide. l,owa s 2�Q�ar�ab — ifl is V'4 Las . *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 1 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 bes f y knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature �. Printed APPROVAL INFORMATION [l Approved as proposed [ ] 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 Zoning Official Date��j��� /� 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 •COM t � a Intake to complete the following: Y -/Q Is use in LI, HI or PDIP zoning? If so, give applicant a Certifled Engineer's Report (CER) packet. Y / Wi I th e 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 o>ablic wa ? If private well, provide Hea $_Dep ment 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 ublic se er? Y/N Will you be putting up a new sign of any kind? Sign permit. Permit # If so, obtain proper Y/N Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Zoning to complete the followings: Reviewer to complete the following: Square footage of Use: ng, 0 6/N ,( Permitted as: /4,k.1-1 , t1 C C 1 ccll Under Section: L!5�,4 , 1 . / Supplementary regulations section: Parking formula: Required spaces: Y/ Iten&e verified in the field: Inspector: Notes: Date: Violatio S. Y. If so, List: offers: �N so, List: 1 /� Varia ce: Y /�N If sb, List: S• 's: Q N If so, List: Clearances: SDP's Revised 1/1/2011 Page 3 of 3 r 1000 Maine ]Hi HilM 30MdW80JN00 NI lON MOM 11VHS doi diNOO 31-ll `AlllIVO03 31-l1 30 NOISSIMd3d 3ONVA0b NI A80M MY SMd0383d dOlOddiNOO 31-11 31 SNOIlIGNOD IV"d* 3N3D '3'S 096'L MOM 30 3dOOS NOISNVdX3 NOIlon8iSNOO iNdN3i OO 30 `d38d SMUS 2 '3'S 000'08 811 JdS x-nn3 2l Vd3N SS3Nisne — o do -113 1NVN3i )81 s0oz oosm VJLVG 1N`dN31 :ON1011f18 JO iHO13H : Nicliino 30 d38v SSO89 :361. Noiio diSNOO :NOISS38ddnS 3d13 :dnOd9 3sn :3dkL iD3'O8d 3000 VJLVG DNIGInS 3S` S 1 18 S31ON )12iOM3SVD )S 321niX13 /!)N181Nn]d VO'`d Id 9N1313D ®31.D33332� E0'V N3933 `S31ON `SN` 9d 111LUdVd `NOLUICIA30 ZO'`d Ia'R S3dkI NO1111'd*Vd II(i `X34N1 !)NIMVdC] LO'`d X 'q CINI 9NIMb2Ia F7 z U, C z H1d0N 3n d!1 VI�V iNVN]1 ONLSIX3 ONIlSIX3