HomeMy WebLinkAboutCLE201100139 Review Comments Zoning Clearance 2011-08-12Application for Zonin Clearance`1'
CLE # 0011 CQ1?A�,,;
OFFICE U NL_'
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PLEASE REVIEW ALL 3 SHEETS
Check # Date:
Receipt #. Staff:
PARCEL INFORMATIO
Tax Map and Parcel: � -M -e yM Existing Zoning I�
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Parcel Owner: 1 1 AknW;nn :T==hC2
�J
Parcel Address:, I ,, City 1 State Zip
(include suite or floor)
PRIMARY CONTACT '
�ylsce_ 1 V Q-1-, 6e GlrQ
Who should we call /write concerning this project?
Address: IS 'S1 SLrmt_r oLr ��k City(2_k .( loA SW P_ State \aJ Zip zZ1?0I
Office Phone: - ` ell # Fax # Ss 1 _1-1A I lo0 E -mail
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name /Type: \J 'k r
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: �2CA04 !W_ �
2 bmhleT
*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 t ate st of knowledge have r ad I onditions of approval, and I understand ahem,, and that I7� will abide by them.
Signa T Printed
APPROVAL FORM TIQ'N
[ ] Approved a roposed [ ] Approved with conditions [ ] Denied
[ ] Backfl� 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 1,24 l/
—A M U I
Other Official Date
County of Albemarle Department of Community llevelopment
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 1/1/2011 Page 2 of 3
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Intake to complete the following:
Y
Is u HI or PDIP zoning? If so, give applicant a Certified
En ' er's Report (CER) packet.
Y N
Wil 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 or p blic water?
If private well, provide Health t form.
Zoning review can not begin unti we receive approval from Health
Dept. FAX DATE
Circle the one that appsignrof
Is parcel on septic or
YIN
Will you be putting up y kind? If so, obtain proper
Sign permit.
Permit #
Y N
W - re be any new construction or renovations?
If so, o tain the proper Permit.
Permit #
ZonincF to com lete the followin :
Reviewer to complete the following:
footage of Use: (3 1
Y rmitted as: r 1 e
Under Section: (X J, d , 1 1 I
Supplementary regulations section:
Parking formula:
Required spaces:
YIN
Ite t1le verified in the field:
Viol ' ns:
Y/N
If so, ist:
Proff s
Y/
If so ist:
Vari
Y/
If so st:
SP's :n
Y/
If so, List:
Clearances: '�
s
C
53 1 k
qM t45(
12024 31 ON-,
�'R ✓
9010 -'Y
15q IqI ) r3O
P'O to
Revised 1/1/2011 Page 3 of 3
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the
owner.
I certify that notice of the application, 70f" UNq 9-ojwN e.
[Cou application name and number]
was provided to �q\ 6p—( U rv3 Q PbmQS —,&r-,c the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number by delivering a copy of the application in the
manner identified below:
Hand delivering a copy of the application to
[Name of the record owner if the record owner is a
person; if the owner of record is an entity, identify the recipient of the record and the recipient's
title or office for that entity]
on
Date
Mailing a copy of the application to NJQ('\ dQf �e. A4-4 � I
[Name of the record owner if the record owner is a person;
if the owner of record is an entity, identify the recipient of the record and the recipient's title or
office for that entity]
on to the following address:
Date
l'j�co4 'Sera- ,u,�1e ' C?� i 1 , 5u le C1�ar 10.5 I le A 2
[address; written notice mailed to the owner at the last known address of the owner as shown on
the current real estate tax assessment books or current real estate tax assessment records satisfies
this requirement].
Date
Rl
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Rebecca,
I think this is everything that is needed for the Zoning Clearance. If
there is anything else you need please let me know. I appreciate your
help in getting all of this straightened out.
Randi Henry