HomeMy WebLinkAboutCLE201100183 Review Comments Zoning Clearance 2011-10-26Application for Zoning Clearance
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OFFICE O Y
PLEASE REVIEW ALL 3 SHEETS
Check # Date:
Receipt # Staff:
PARCEL - INFORMATION
Tax Map and Parcel: Existing Zoning
Parcel Owner: As w se T t i a }a t t_t_ , web G Ot°4V_ MT i e S.
Parcel Address: 11-14 gi D +t iL.t CFtJmn— CityCf't�►It t.O tt+�6V i tate V�" • Zip
(include suite or floor) tJ rw L OCa►.10000 11J pe.a2a„
PRIMARY CONTACT ,
Who should we call /write concerning this project? tM 1=�f= �M x41.1 _lire i2.SGN.A*,e,� ,lt.izCH i ttEG'(",$
Address: 25po 1 EVte.c2.Y (a 04p City GL.FLvEtA.LJ0 State Ai-t'0 zip I'l12$
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Office Phone: (21� 223 32UOCell # Fax # 223, + .3 2-(01 E -mail
2.il : '►rr.E±e,�aa� C� G+ersc4+,tic�aa�cfn14
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New basinese
t_c�cp.�ri.
BusinessName/Type: ToAww FA.saiG i&uc, CRaFrs
e�
Previous Business on this site KEkI's �'�� NL1 `eFo'RN OV S'COt ,, I N P�a2d RCL oGA� V "P to t.1tz.W I.
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: f2 qrA % t ZTC kE
*'This Clearance will only be valid on the parcel for which it is approved. If you change, intensify or move the use to anew location, anew 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 Imowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
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Signature Printed i Nom-- F!2 E tc rtt ,A ►.�
APPRO 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:
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Building Official Date l Orr(
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Date IbI�����
Zoning Official
Other Official Date
County of Albemarle Department or community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 7/1/2011 Page 2 of 3
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Intake to complete the following:
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Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Reviewer to complete the following:
Square footage of Use: -10 . , � b
fitted as:
iolations:
so, List:
o(fI S.
If so, is,
Will Nere -be food preparation ? - - - - -- - -- - - - -- -
- Under_Section:-
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from Health
Supplementary regulations section:
Dept. FAX DATE
V is a
Y
If so, List:
Circle the one that applies
Parking formula: LL
Is parcel on private well ublic water?
If private well, provide Healt epartment form.
Zoning review can not begin until we receive approval from Health
Required spaces:
Dept. FAX DATE
Clearances:
SDP's
Y/
Circle the one that applie
Items o be.verified in the field:
Is parcel on septic pablic ewe
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Inspector : Date:
Permit #
Y N
Notes:
Will there be any new construction or renovations?
If so, ob v e ope Pe t ((jj
Permit #n iftA �v
iolations:
so, List:
o(fI S.
If so, is,
0 L/
V is a
Y
If so, List:
SP's:
'
If sd�List:
Clearances:
SDP's
Revised 7/1/2011 Page 3 of 3
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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_----- - - - - -- - - -- - _— -------, V��+ �-- FI+; �icZc 'G:— �•�c7-- C2At— *'$---- - - - - --
t 1 '14 210 4-41"t- C 1E cv T`e (L-
I certify that notice of the application, e_ Cu W -rl C;f A x-13 F,_r4-" XrZt C„
[County application name and number]
was provided to A. EW SGT R.10 f-1 t t-t- t -C, the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number 11-74 t? c, tt t__ e_K 0%eRby 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 &ENJ S GT' it t eD #-t t c -.t... L L 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 — (9 — Z y 11 to the following address:
Date \ f l tr- W #j 4 ) VA .
22t82 ,
(Ze>SrEQ -rW&L 17Rof'et -rt1ES 6391 OLD Gov2T+- t&US4. R.04t> 3ZO
[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].
mature of Applicant
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Print Applicant Name
ID-19 -2011
Date