HomeMy WebLinkAboutCLE201100124 Review Comments Zoning Clearance 2011-07-01Application for Zoning Clearances
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CLE # Z.
PLEASE REVIEW ALL 3 SHEETS
OFFICE U E ONLY r +
Check # ()Z2_ . Date: to -N " f I
Receipt # Staff:
PARCEL INFORMATION n
Parcel: L61 "�� - � � r ' Existing Zoning � l ` &Ymr PA'
Tax Map and I/\Y
Parcel Owner: -U,iA� UL
, / 2
C � ��� �� 2322,10
Parcel Address: '560 City (N 1f�� State V -Zip
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? e— _0, �l w
4A _ Im Zip Address }m litX City b 2
Office Phone: t � ' rl 95' % 7 Cell # � / -2075_ Fax # !971:Y733 E -mail Icy On i F C9 j o- Coi
APPLICANT INFORMA ON
Change of ownership Change of use Change of name New business
Check any that apply: C h
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Business Nam e: (u e—ru• C2 Gromp LLC iry �1� %ell
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Previous Business on this sited 46 Wm- �Q�11�V, 2C- , 'PC
Describe the proposed business including use, number of employees, npinber of shif ,-available parking spaces, number of
^
vehicles, a d.a y additional info rm ion that you fan provide - (fit ird / tOVi _ wr O Q2.
*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 h the own ' pe o use the space indicated on this application. I also certify that the information provided
is true and accurate to the be f my wle . I have r d e condition approval, and I understand them, and that I will abide by them.
C ��'
Signature Printed
APPROVAL ORMATION
Approved as oposed [ ] 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
5555. ,
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
Intake to complete the following:
Y/N
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y N
Wil re 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 public water?
If private well, provide Healt Deparhnent form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that ap lies
Is parcel on septic or public sewer?
Y N
Will ou be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y
Wil ere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
ZoninE to complete the following:
Reviewer to complete the following:
Square footage of Use: 1 � &Z
0 er/N ��
mitted as: Y4 e
Under Section: Z 2
Supplementary regulations section:
Parking formula:
Required spaces:
�f
Y /
Items o be verified in the field:
Inspector•
Notes:
Date:
Violations:
& N
If so, List: �y l � n
h �V
Proff
Y/
If so, ist:
Varia ce:
Y/
If so, List:
Y/N
If so, ist:
Clearances:
SDP's
Revised 1/1/2011 Page 3 of 3