HomeMy WebLinkAboutCLE201100201 Review Comments Zoning Clearance 2011-11-23..... _— ............ ._.
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Application for Zo -ing Clearance
CLE #
lOFFICE C ' ��..jj\ _ Y, �6
_. _"C.....— Staff: I
1'I�.E?.SE REVIEW ALL 3 SHEETS I
Check Tate:
Receipt # . _
PAItC rI, INF0R--M .'r10",N
Tax Map and P u c el; 07800- 00- 00 -055DO _ Lxisti,t;; Zoning PDMC _
ParcelOwnei-: Luxor Office Park. LLC
t'a,•celAddress: 1430 Rolkin Ct, Ste 103 CityCharlottesvi.11e State VA Zip 22911
(include suite or 1100")
PRIMARY CONTACT
Wbo should Nve call /write concerning this project? _ - -_ -_/ �c>' _•, I(�1 ._.__. _
Address U City _= iri , i (-+State i `� l•ip� ✓
Office Phone: O�TCell # Fax u j- �j S1t ��G ►� ai] 'ffo�. dC9e- i"ts @ � �f _
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APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use �— Change of name _��evY business
Business Name! l ypt"
Previous Business on this site. Not Applicable - new construction
Describe the Proposed business including use, number of employees. stun >e * of hit a> nilabl a Pal-king spiees: unml ?c" of I
vehicles, acid ny a )ition it in.forirtation that you c:nt provide: 1 ,�_L n G
his Clearance will only be valid on the parcel for which it is approved. 1'f y0it change inter ,iy or move the rse to ti new7ocation, a newZonirig
Clearauee will be raquircd. r
'i
f hereby certify that I O1uwr ar-t wner's permission to use die space ]ndicated on this application. . d I
is.true and.acemate to fl ly know, ne. I have :read the conditimis of approval, and .I understand them, and Lbat i will abide bytben?:
Signature' _. _ _._. Printed "
A :PROVAL INFORMATION
A.i mroved as or Ouse d [ ? Approved witil c ondit o
] Backr1ow)?t eventio dev ce and/or current teat data needed fa- this site C on:a, 1" SA, 977-45.1 1, x l 17.
[ ] No physical site inspection has been done .for this clearance: Therefore, it to not a deteranunatioiz oi'comp lance with the ex stircy '
site plan.
[ ]'Phis site complies with the site plan as ofthis date.
Notes -- -- - --
T3uilding Official �, c--.rr �- �-�-9 Uaie
/oning Official _ llate
I ,/
Other O(tici71 L ?, to
Uou lttv, or -ra,u etnar,e J.,ep:T r In) ell C m UO nnn ITT uy ,.naVcu, to a MILL. -- ,
40 LN- lcltttire total Char- lottesville, VA 22902 Voice: (434) 29(i- 583213ax- (43 3) 972 -41.26
Revised l/V201 1 .Page 2 of 3
Intake to complete the following: Reviewer to complete the following:
Y �/ f Square footage of. Use:
l.s a u7 L1, Hl or PD[P zoning? :[f so, give applicant a. Certified
Engineer's Report (CFR) packet. / N
as: _�i _- _......
Will there be f.•ood preparation? Under Section: -2 /
I
If so, give aPplicant a Health Deparunent form.
"Zoning review can not begin until we receive approval from :Flealth Supplementary regulations section:
Dept. FAX DATE . ........ - - .............. -
Circle the one that applies Parking fornialu:
Is parcel on private tvcll r 1;itblic wa'tcr
1f private well, provide Hew ffi epartment form.
Zoning review can not.begin until we receive approval frown Health Required spaces:
Dept. FAX DATE -- —_ - - -- - -- ._
applies dies ems 'o be verified in the, field:
;Circle the one that 1 1
1s parcel on septic or ublic sewers
%ill you be putting up a netiv sign of any kind? ifso, obtain proper
Sign permit Zv��2 j Inspector : Date:
';Votes:
Y��i it
tiZ'ilt there be any new construction or renovations? -- .
1" so, obtain the proper Permit. -
Perntit# B2011-01881—AC - --
Zoning to complete the tollowing:
VIUI Dt: ' s
y
rofl'ers:
Y
l:f so
T so., List:
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SP _s:
'aria ice:
?�
Y
lf.so, _tst:
l[so,List:
G• /7
-
V
Clear"Inces:
SDP's
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Revised 1/112011 Pagc,3 of-3