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HomeMy WebLinkAboutCLE201100153 Review Comments Zoning Clearance 2011-09-16Application for �ni n Clearance I � ��� J Cd' . °tr '`m _,,:, CLE # 1 ,y PLEASE REVIEW ALL 3 SHEETS OFFICE US Check# Date: ?S f Receipt # Staff: PARCEL INFORMATION f'/ Tax Map and Parcel: Existing Zoning U Parcel Owner: ILOM C� I �,�a Parcel Address: 726 to U to City U 1 -2� State . Zip (include'suite r floor) PRIMARY CONTACT Who should we call /write concerning this project? Address 1K6. WV" • ! GdCity AoA- (; Jd tAd rJ State 00— Zip z7f s Office Phone: 6 /- Cell # • 2 T Fax # E -mail CV PL —C @ ! j& Ly . Gd ✓h APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business 11 Business Name/Type: �l S = G 5 •, Previous Business on this site l C U L'dS .o l.lv L o-,rW a5 Describe the proposed business including use, number of employees, tuber of shifts available parking spaces, nu ber of l � vehicles, and any additional informa ion that you can roAde: S O 7i *This Clearance ' 1 only valid on the parce 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 ave the o er's permission to use the space indicated on this application. I also certify that the information provided is true and accurate to es of my lcn ledge. I have read the conditions of approval, and I uryderstand'the , and that I will abide by them. 1 Signature Printed 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, 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 'T1 I Zoning Official Date U111-2,411 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 Intake to complete the following: Y 6) Is use in LI, HI or PDIP zoning? Engineer's Report (CER) packet. If so, give applicant a Certified /N ill there 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 - k �.(ar,v .� rMij- fM� Circle the one that applies -� Is parcel on private well ublic wate rJ If private well, provide Healt epartment form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applies Is parcel on septic o ublic sewer? P/N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # 3!/ 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: /a. 0 J /N Permitted as: e Under Section: Z• Supplementary regulations section: Parking formula: /u J Required spaces: r Y/ Items to be verified in the field: Inspector : Date: Notes: Violations: Y /ID If so, List: Proff s: Y/V If so, List: Variance: Yel If so, List: SP's: Y/ If so, ist: Clearances: Revised 1/1/2011 Page 3 of 3 Yy FAA. R CL VI 61 too 1� ® b 4�e d i II E e,Aj-e, fi r CaNOF� �d ke- rt MOM eA.10(5 wl 13441�5�15 64e.- �2FVi�J ol oor .w• p ort:fzl ►4 a st qy ...4 E 4' c 15 4 two [ 2 .. U GC•L,. NNADE A5SOCIAtES ii6r.rE[J T M 6 O Po rce 1 40 92 Percet X If a to m It O to N W O C6 TM 7 Parcel 1.IU 9078 .0 \ • O. O gt. Anne Scnoot \Y .,• PLAT SHOWING A SURVEY OF Z PARCELS 'W', X Y. EI Z r .0 .< Il ryit• �,� F'n-perty of Colonnade A ssoc,ates Containing 190sf, To Be �\ r < •? .mil= •- Force.l W, meted Partnership - - conveyed Tr And become Fort GC Ftoperty Of 6a►COro M t TO:Dt:tt, Ceslgnated As Lot 2B- 3,Um.erslty rteghts .. c° V t Po %cqt X ,Pr�rerty ct 6aruoro M Toiaott, Ccntatn :no NOsf, To Be Fropert y Uf C Tc And d ecomt Port Of olc nnode Associates o L i' 1 -7 u C9 Z 1 ' v ;cove /ed L,m,ted Fortnrrsn,p , Eeslgnoled As Lot 26- L,Untversety Heights 1 _ -' Z Z �, '1'r'trty rf St &one`s School, Cunfolnlna 4 W sf, To Be C ri, Q =� , 'A n.cek �1'+r (,-i e I e d Tr and Brccme Part C Frpperty Uf Baraaro M ( 1� � �► IL t .. To!outt , Designated As Lot �,B- 3, Unlversltt Herphts <; > ^.- rr pertrCf 6orGore M To bolt,Cuntomin9L-Elsf,ToBe V 1 '-t.norwed Tc. Avid Became Port Of St Aones School, t+eslgnoMd �� rn G: c•o•crl I.IUun Gtly To11 Map 7 PA RCE -S r/U "Ond•X" ARE LOC:.TED IN ALBEMARLE COUNT '. I r; E S "Y "ond' Z" ARE LUCA TED PART_( IN ALEG MARL .E "o�Nir ANG P;.RT..r IN TrfE CITr OF C MAR LUTTESJILLE V1 foul NBA -.. - -i WILLIAM S. ROOD BU.S. IN't - cwwiw.4ra•Lend Sutver ►s•Lf�nOPloett�t,Et• �� 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, L or. \Y-\ Q C �- [County a plication name and number] was provided to x the owner of record of Tax Map [name(s) of the record owners of the parcel] and Parcel Number C OCCO " 00° W-- 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] Oil Date Mailing 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 to the following address: [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]. 7 Signature of-Applicant / I o © ( I Print Applicant Name Date