HomeMy WebLinkAboutCLE201100121 Review Comments Zoning Clearance 2011-07-01C1q Q
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Application for Zonin Clearance
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CLE # a & '- /;
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Zoning Clearance = $J5
OFFICE USE O Y , y�
Check # 2 / Date: 9 1
PLEASE REVIEW ALL 3 SHEETS
Receipt # Staff: c f%i /,Gj%"�
PARCEL INFORM TION (� y .��//
�6Tax Map and Parcel: _ ^7U / ,2.xisting Zoning RD P4 C
Parcel Owner: i �''4`1"'� p/l.(�P1il!_�i l 2 S to
. Parcel Address: (J l ��''� 5 2^; �. '.S`'� -Z6 City C ✓ t L kA_ State (�� Zip �t
(include suite or floor)
PRIMARY CONTACT PL-01's
Who should we call /write concerning this project?
[ S cLA t VAn4S• ( ,4b, s�ttx ZnLS
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Address: � �-�� ' `� ' "' `' "� City C•lt Lay, S o-4_State y� Zip ZL��
Office Phone: (� ?, >. iUCell # (1-3'4419'. Fax # kA -'J°t . ZS'S E -mail
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APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name 1/New business
Business Name /Type: 2 "L✓ C> CO ,O& S r— O Lr$- � 6 (a /, - C. w O JZ
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Previous Business on this site t i-A S4_ ��o®= - �e/1Alq V
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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: LAC,,.) rt t-' . 4 2 , ✓��� S `f � cS � �-a J
*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 have the owner's permission to use the space indicated on this application. I also certify that the information provided
is true and accurate t the best of m/y�knowled . I have read the conditions of approval, and I understand them, and that I will - abide by them.
Signature V • Printed�.t"" "� • l'ldlr
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APPROVAL INFORMATION
Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Backflow prevention device and /or current test data needed for this site. Contact ACSA, 977 -4511, x119.
[ ] 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':::--:N— �— Date G�((
Official ��/ Date _71i / I
Zoning _�
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 04/28/08 Page 2 of 3
Intake to complete the following:
Y/®
Is use in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
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 public water?
If private well, provide Hea ent form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that ap
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: 5 Ub
ON
Permitted as: 0-M L{�
Under Section:
Supplementary regulations section:
Parking formula:
Required spaces:
Y/
ItenbkKbe verified in the field:
Inspector : Date:
Notes:
Violations:
Y/O
If so, List:
P ffers:
V1N
If so, List:
Vary nce:
YO
If so, List:
SP's:
Y /�N�
If so, is
Clearances:
SDP's
Revised 04/28/08 Page 3 of 3
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706 S9 F1
Suite 202 -B
Suite 202 -B
Suite 202 -B
suite 202 -F Suite 202 -E Suite 202 -D ���
Closet Clos t Foyer
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Suite 202 -B � - i Elevator
Kitchen
Suite 202 -F Waiting Area
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,
Suite 202 -F Conference
Suite 202 -A
Suite 202 -C Room Closet
I" Reception
Back Entrance
hone/Da Platt Financial
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Closet
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