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HomeMy WebLinkAboutCLE201100184 Review Comments Zoning Clearance 2011-11-08Application 1 ®1 ®nin Clearance ©0 � CLE # Ct OFFICE U N Y PLEASE REVIEW ALL 3 SHEETS Check # Date: -' Receipt # _ Staff: PARCEL INFORMATION Tax Map and Parcel: Existing Zoning e o mme► -n a� 0 Parcel Owner: COX 11ropey , es "C Parcel Address: ILilLP (;re-enbrier ' Izm City L�avjbf{ebv;11-e^ State VPr Zip 2201(31 (include suite or floor) PRIMARY CONTACT Who should we call /write concerning this project? ke-kl ; a i 644 na er- Address, Ysan i�art<w2c�t City C)1a.r)(s4-ksvi ))e State VA- Zip ZZg11 Office Phone: (q%q) q'79 Lol4A0 Cell# 0IN Fax# (43x) q-7j U 18tE-mail M eA,'SS2. APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business Name /Type: zoyn•,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: Cnrpc ra-Vc 6J(A-e.e SQAu, Le em pl.s.4pts. I Sl,;A -, 10,21x0 Sc�k Un�ss;cneci �avk� In ye1��ClPS *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 he best of m owledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature Printed C 1•bra o M. b 1W12r� APPROVAL INFORMArqON Approved as proposed [ ] Approved with conditions [ ] Denied [ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, xl 17. [ ] 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,,., �"` Q�"'�`'''� Date o Z r Zoning Official ---7� Date —� 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 7/1/2011 Page 2 of 3 Intake to complete the following: Is/ IsusVnLI,HIorPDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y/1 Will t 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 or public wa er? If private well, provide Hea Department form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applies Is parcel on septic or pu is sewe ? Y/N Will you be putting up a new sign of any kind? Sign permit. Permit # If so, obtain proper Y/N Will there be any new construction or renovations? If so, obtain the proper Pen-nit. Permit # Zoning to complete the following: Reviewer to complete the following: Square footage of Use: 5 /� d/ N Permitted as: �e e (,Q—, Under Section: 2-3,-2,/ Supplementary regulations section: Parking formula: J Required spaces: ` Y/N / Items to be verified in the field: Inspector : Date: Notes: Violations: Y/I If so, ist: Proffers: Y/N If so, List: Variance: Y/N If so, List: SP's: Y/N If so, List: Clearances: SDP's Revised 7/1/2011 Page 3 of 3 7.7.._ —..—_ —13 W4— ri 2-4 sf, I 0 W (D CD 0- CD C (D C CD D ti ri 4-1 CD H � _0 -0 E, 9! m 0 m po CL -Uj (D I,\- CD 0 I,\- CERTIFICATION THAT NOTICE OF THE APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER This form roust accompany zoning applications (Horne 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, Cle [County application name and number] was provided to Qo X 'Pro Q t.l,.0 the owner of record of Tax Map [name(s) of the record owners of the parcel] and Parcel Number 0Lu 1 W O - o 1- oo - ao i g o by delivering a copy of the application in the manner identified below: Hand delivering a copy of the application to [Naive 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 Cox In) per-h es LLC, 1 rvir, Cu-c [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 10 Iq) l i to the following address: Date 528 Qokwooui "Plaae. CJzrl64es 611 -e yP-Zz9g3 [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]. Signatu of licant Print Applicant Name Date IU11-110