HomeMy WebLinkAboutCLE201100207 Review Comments Zoning Clearance 2012-01-04Application for Zoning Clearance rance
CLE#- 03-
PLEASE RE VIE W-AL-L', 3'SHEEW
OFFICE USE ONLY
Clieck•,W /g5 .2' bat:
jZqgeipt# 'Staff.
PARCEL INFORMATION
Tax Map and Parcel: X '90 -00 2- 0 Existing Zoning
Parcel Owner:
Parcel Address:_ lgezL4%e-Lito r Lt:�C-Qv , CRY state 'VA Up 51PI
(include suite or'floor)
PRIMARY CONTACT
Who shovl&we call/write concerning -this profuti, 6: t) r"
Address: state. Zip Z-t-9j�j
V
Office Phone;'.(' F X# E- ruail i�A LLL/ -o;K0
APPLICANT INFORMATIO:IV
.Check any-t at'ap a e 6f ownership_ use
h ply--,.��Eh ng lyn hip, ich —ghil g6AD
Business 'p
-i
Previous usiness, anA h ig,site
Oe-scrlhe- the epip-pose- d:busm, ... es- including use ,iiiinib6:4.employees, nu wt ' b f shifts; avatlAble i parking spaces, 'Jnumber of
Vehicles, and an d, a ditionifitif6fingtionAha-Y t 04 C'Anpyqyj e: (I •
t4� _7 t
*This. Clearance wtll,only" be valid -on the parcel !,f6fw Y.. .
Ts�fo ---I.- i- f I" - . - I I z
n.epsi. .,pr, -Ihd:iii6A6 ocatjqi�* '%,Y
rnpvt Y�Appmv
Clearance wiJtlie required;
that I o' "I
g0l thd n.pponsof approva 1,.;and 1 understand them and 'thk] : fir
Is true and accurate lo,the best .6f-Ljiy ,-, re th `--affi
e, aye- a e co
Sigfiatiire
APPROVAL :INFORMATION;
IW Approved .-p-sproposed
d6vice Emd/6rpurrert'fe td
data sieeded, for this -site .' Contact rACSA 977-4 51
[ . ]-Nb ph !Ysioalsit inspec ion,,hasbeendone --, of,this !.Oeafafice. Therefore, 6rmhati
P19,
Fte.p.an.
sftdionriblks with the site plan as of this date::
'NOtes
nwoffi
4-'rj g, D ff A J�ja
bn -Dail
Other Date_;
county of Albemarle llepartment;of 'D0*l0pm6 t
.29 -,5�32, sk:�:(43.4y972-' 12
do ice F
16, �VA2.2 02 V6' -4 6
Revised a 1-f1)2,01 1. Page .,ZVf,-3
Intake W complete the fojlo-
WIN
Is use in LIj FU or PpFzoningl— if so, giveapplic4nt a Certified
Engineer's 'Report ,(CER) packet�
Will 9there beTo.od,pre0aration?
If so, give applicant A Health Department form,
Zonirig review can not begiri,until we receive appr6va
l'fr-0
fti'H6alth
Dept, FAX XDATt-
.Circle the one that applies
Is parcel on private�wOil o publi c- w"at
If pdvate well, provide-. Heal ffhDq7partment Borin.
Zoning review can not 4qgin, until Wexecaive approval fforhllealth
Dept. FAX DATE
Circlet . heb ' nit that applies.-
Is parcel on septic 'o "bli 'tewem
Will .you eputtipg' p4mq
'�y ou b-
Sign pe-an1h.
Ternilt 4"
Wi ebe'a
Opy new constru 6onror.,re- avatiohj?.�
Y-- so, iobtain the P r"op, Permit or
I6 to t
Re,Oewelr t-o"complete the folloWing:
Sq uare foota g-d
, 017use:: 7(Oob
I N f) r.
Pennifted'a
Under Section: _
Supplementary regulations section:
Parking formula:
Required spaces:
/16
Items to be V.eHfiqd4n the ,feld--,
Inspector .. -- -- Dute. ___-
N . atesi:
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