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HomeMy WebLinkAboutCLE201100211 Review Comments Zoning Clearance 2011-12-28Application for Zoning Clearance `''y� CLE # J b 11- 21 t 1� PLEASE REVIEW ALL 3 SHEETS OFFICE USE O Y Check # a D Date: 12-21-11 Receipt # L Staff: nrly l PARCEL INFORMATION 11 t1 Tax Map and Parcel: 32, 3-7 A (032.00- Q0- 00- 037P101Existing Zoning U C Parcel Owner: Anfhorlu and Mary Kav Valens u, bmse i- L.LC. Parcel Address: 3440 Seminole -Tr. Suitt ID5/ city CharloffayJIt State VA Zip 22811 (include suite or floor) 100, PRIMARY CONTACT Who should we call /write concerning this project? �Jmberlq Mabko I Katural �4 E65Wh0l5. Address: 3440 Sery ina It Tr. Suite. 105/ Citylharlof"fayi I it State VA Zip 22q 1 Dlo Office Phone: 4( 34) R7cl - 5779i I Cell #211-1&4-5113 Fax # 434-879_9711 E -mail jnf0p CVI Ile WeS5eY1US. APPLICANT INFORMATION Check any that apply: Change of ownership Change of use ✓ Change of name New business Business Name /Type: Natural T& B5e.Y16 CA 1 LI,C, / ?Q. L ll I Previous Business on this site N aiw -f-'s 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: one e ploVjte. ; one. 5hiff, , DaMign Iv} sot spaces, 3 handican2cd var4N soaccs rear empygtt_ Dar ©ru ypA,ide. *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 knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature GL1+C Printed a un a Q 0 Ptk &AXAk_ZiW I LLCI Nafivral '�.� ESSCH-0-K LEC 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: —°'° Date Building Official Date .� Zonin Official ✓ y� Date `! g- 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: Y /(Is us to LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y /.0 Will 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 Circle the one that applies Is parcel on private well public water If private well, provide Healt Department form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applie Is parcel on septic o public sewer? Y,/ N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # 16 aiOC2.55 Y / Will here 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: .2,6 -�C tj/ N Permitted as: d-,A -A Under Section: Supplementary regulations section: Parking formula: Required spaces: <,/ Y/N (( Items to be verified in the field: Inspector : Notes: Date: Violations: N If so, List: f 1 l Proffers: Y/ If so, List: Variance: Y / 6r' If so, List: SP's: / N If so, List: Clearances: SDP's Revised 7/1/2011 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, Zon I nQ C l e ara nC 2- [Cou ty application name and number] was provided to S unS e,� - 1_ LC, the owner of record of Tax Map [name(s) of the record owners of the parcel] and Parcel Number-3.2- 3 7 A by delivering a copy of the application in the manner identified below: Hand delivering a copy of the application to M h o n V + M a rq (x\l V irk +2 [Name of thd record owner If the re ord 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 [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]. Signature of lican �u rnbe►'IU M.afi-sko Print Applicant 14ame 12%21 2011 Date \I -T( M? A a I DS I t)',P Wo S+Occ)le,� W.- AOD A Lxsp 4,4,( 5jA7l-- �Ixselrl VJ su rfe- /06 c 1. i;O- � V?s