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HomeMy WebLinkAboutCLE201100122 Review Comments Zoning Clearance 2011-06-29Application for Zonin�Clearance "t CLE # �11 - / ? '� PLEASE REVIEW ALL 3 SHEETS OFFICE USE ONLY Check # 1,5J5 Date: Receipt # 3 sg'i Staff: PARCEL INFORMATION Tax Map and Parcel: V b ©O Q '�00 �,�5_00 Existing Zoning �0 e(�MM12,T i it I'F If ----pp._- f1� Parcel Owner: � ff o n --bl /g"t Y6o rt-k" )�i [�Ydf f irJra Parcel Address: a?491 1`rJ N/ hod City 0ha1'10 4JeSV; j le State Zip Z645 (include sfaite or floor) PRIMARY CONTACT -- �l7Lf F Who should we call/write concerning this project? /L'Mi? /C' ` / Address • ®. [�}C I I City Chc�l lto 1(�s ve 1 �? State l% A Zip-70,A j - Office Phone: E7�a Jr'�M - i�G�S Cell # Fax # E -mail 10 (1 Lt �f a, Jew4 -Ko C& C APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business tin i i nL G. rre^� rub Business Name/Type: Re ` + aI ) Re 1 a,Ll Zne_ .. Cl hiL Re litq -Cod s'C`D/r� SC.2(es Previous Business on this site Describe the proposed business including use, number of employees number of shifts, available parking spaces, number of vehicles, and any additional information that you can provide:�?m./I��cf��S W9 11d,t/f Ao-i'-a,,1 d gn Qz)+ azotu r c� 5sa,� fie: �nrwf car u 1ci „ia ✓ trmltt *This Clearance will only be valid on the parcel for which -it is approved. If you•bhang , intensify or move the use to "bw location, a new 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 accurate to the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature ;A(r n l ieLQ_ Printed A-P MON `GAT APP OVAL INFORMATION [proved as proposed [ ] Approved with conditions [ ] Denied [ ] B ckflow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, x117. [[ 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 e Date C_ r� kk I ft t /1 Zoning Official 6btb Date �� �Q f f Other Official Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 9724126 Revised 1/1/2011 Page 2 of 3 ym d' v Intake to complete the following: Y /�Nf Is us 1 LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y 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 or JZ lic water? If private well, provide Health ent form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that 5Aes i Is parcel on septi ublic sewer? Y Wi ou be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Y Wi iere 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: �No Y N I r o n ermitted as: s, ll., yyy ll ��Under Section: Supplementary regulations section: Parking formula: Required spaces: Y/N o Items to be verified in the field: Inspector• Notes: Date: Violations: Y/N If so, List: Proffers: Y/N If so, List: Variance: Y/N If so, List: ' s: Y/N f so, List: t oC O G Clearances: � �n � , � � I _a Ts SDP's jI 9 Revised 1/1/2011 Page 3 of 3 r ir z D �� m loo I � D —I p w z �, \`. O O m .•��o. ,. lEMt=,Mm-=MLq 013 0(3 r br nt r: STONEH 2 I. s ..­---��.. FI\-,, 1�1 11 11 D �► AUS GROUP 1 WAM D C Cn O O C