HomeMy WebLinkAboutCLE201200011 Review Comments Zoning Clearance 2012-01-23Application for Zoning Clearance
3z
CLE# %Q- -I1
�., �n
� %ROIN�P
OFFICE U E O LY
� opo Date:! -191 Z
PLEASE REVIEW ALL 3 SHEETS
Check #
Receipt # Staff:
PARCEL INFORMATION (�,n
Tax Map and Parcel: JA" 2O , OgOOh—bnn— CQ —OO '7DO Existing Zoning V A_
Parcel Owner: t 15k ri C,
Parcel Address: rit7 � , udo U', t V�� City State Zip M
(include suite or floor)
PRIMARY CONTACT c
Who should we call /write concerning this project? V cl w J• ba 1ni t_.
Address:10I Qe4. ank[in S�YP�e� City iy lhmonC State A- Zip2zzzo
Office Phone: M(#4q-4eool Cell# Fax# &A - (00A (&E-mail V;&q.e6Aie1
jefferswKc4e
APPLICANT INFORMATION
Check any that apply: _�/_ Change of ownership Change of use _ Change of name New business
n
Business Name /Type: -N-4.) cl C— k4'L (5 cf A') (v mar l e_ , (-Le-, l Ply% I
tol
Previous Business on this site— V 2�ui1G� d
Describe the proposed business including use, number of employees, nupiber of shifts, available parking spaces, number of
vehicles, and any additional information that you can provide: b�2 itiT �G� l/�rcl►'�-k �5 o e �� uLAXS
*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 acc�u(raate to the best of my knowledge. I have read the conditions of approval, and them, and that I will abide by them.
iI,understand
Signature �i C-1 .u�l Printed Iii i�t �� � �/►
APPKOVAL INFORMATION
[ 1,rApproved as proposed [ ] Approved with conditions [ ] Denied
[ ] BAckflow prevention device and /or current test data needed for this site. Contact ACSA, 977 -4511, x117.
[L,kNo 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 Date t t
Zoning Official Y_g,?C1021J Date f ;2 3119,
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
�a
Intake to complete the following:
Reviewer to complete the following:
Y / N
Square footage of Use:
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y / N
Permitted as:
Y/N
SP's:
Y/N
If so, List:
Will there 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
Circle the one that applies
Parking formula:
Is parcel on private well or public water?
If private well, provide Health Department form.
Zoning review can not begin until we receive approval from Health
Required spaces:
Dept. FAX DATE
Y/N
Circle the one that applies
Items to be verified in the field:
Is parcel on septic or public sewer?
Y/N
Will you be putting up a new sign of any kind. If so, obtain proper
Sign permit.
Permit #
Y/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
7 . 4 1 +0 41.n �nlln�x inrs•
Inspector:
Notes:
Date:
.� ..... _ -- ---- ---- -- - --
Violations:
Y/N
If so, List:
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
` owner
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,
[County application name and number]
was provided to the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number
manner identified below:
by delivering a copy of the application in the
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
[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 Applicant
Print Applicant Name
Date
... BSOSF
Oubha
44DD SF
7 L
i C
1650 SF 30DSF
P
§
CD
)
.
»
�
\
a
r
u
.
Li
0
/
/
E
t
CL
.G
:3
5
co
CD
E_
R
/
p
f
ƒ
E
/
g
u
2
uj
■
m 0
7
/
E
3
k
o
@
0
0
0
o
e
=
o
\
\
\
f
f
f
f
\
f
S
S
E
S
S
R
/
§
(
§
§
\
(
\
§
E
E
E
E
E
E
\
f
A
A
A
A
A
A
L
G
$e
/
§
§
§
§
§
§
52«25
2E
%
31$5
2
2
2
2
m
m
m
m
m
n
o
m
m
n
e
m»
m
F2%27
/n
F/
\////2
E
{
\
/
/
\
\
/ 0
m
7
y
$
%
«
7
/
/
f
/
w
g
e
e
k
/
$
0
/
/
/
/
/
/
[
5
/
/
2
G
§
}/E
E
///
k
k
0 c
�=
n
e
a
o
g
o
@
@
§
e
7
e
o
/
/
_
-C
eke
5
m
°
fogoa
tom
=
5
5
k
\
/
/
/
o
/
m
/
/
&
»
n
§
/
»
/
»
q
e
F
E»
Co
o
±
2
E
0
/
/
\
CO
2
o
E
m
./
M
m
2
m
(
e
.
k7
e
/
/7mE2
a
2
@
%
s
R
=
\
0
C/)
e
§
»
>
§
.
R
CO
cr
t
®
®
Cr
/
w
®
2
U)
�
k
�
/
\
\
�
Co.
/
\
C�'
CCT
2
CO
/
\
d
�
w
D
/
/'
/:
E
O
f
<
R
�
?
®
3
/
E 7
p
Z m
ƒ
/
ui
-3
J
/
/
2
2
*
co
U)
/
/
2
2
\
<
LU
/
ƒ
/
<
/
O
ƒ
Pel
ly
10-1
IWI
wl
1<1
0
1
101
CD
)
.
»
�
\
a
r
u
.
Li
/
/
E
t
CL
.G
:3
5
co
CD
E_
R
/
p
f
ƒ
E
/
g
u
2
uj
■
m 0
7
/
E
3
k
063 064 065 Cb
ti W
O
093 094 095
Albemarle County Tax Map:
Scale RR
0 900 1,600 2,400 080
O
Fiatf
? Note: This map is for display purposes only�py
•, and shows parcels as of 12131/2010.""'
See Map Book Introduction for additional details.
• 64 -108 •�
r \ d zz
)i90
' ...
7
Q o0 0� \ � �,\ F O•
G A L
t
cpo ' . "i t •\ '� V Q o � - ^Og V �°tic�P %j
\ A M ,,� � Opp 'x 7�31f, ''•\ ��:5
IA .y �2yorj 8�
X69 �
w� 17���
\, \
N�, � `�� � �, r�O 11 X20 : �� ��D vo ^�� `•' X81 -7
731 9 ��0`
1
CSX INE 109�3p 1 3 � ���•\ ��P ��� Q) \ i' w
y
�✓ 0
:lg� � o i � �t.' , o �,� �, ��� I: � O'o 101P �s�c, ^�6 •, o' 00
�� 00 ��fG�� ca10H10G° � q06 ^rod LO
W a��D°X � 7D �• s� .,�• `� �G �a �.� `s 10� p' 1 �S ; • �.. -_ �t a1 �4 ,
�o ...- ....,`••\
\�sTk '� ... �y218 �4a oo Zo �p� �1�,1 • ,. S.f-�' Q 61L 921 , �� �OV�g � g� ,8p '�O 74D aE 3P2'13P1 •...
�G`L 61 M .' 9/,j, ioW � � 0 1 '•\
>p w sae
80 -73A `•.,
93 �;.. -• � �G
�� � 31 3 � � � G�O`. 61 E2 �>v� ���•1oz. 61 80-
Ric 9 �2 0 `b •. 1E3 0 0�', 61 B '' c J73 ��..
y
` }: < +j' � �8�''3• "�'�?q5P /y`" 6'0�,.
,.' Sgg �c�,�uoK..._..., * -- �Q � �`°� 9H g9� s1s � .� ,� •� �j
1i vi G h rL 2S 91 8
'•a'1• "� pgP 56�, ' _ � �, �g O� 6 .� r . 62c6�ry\ 6`i'J � � 9s'd �.
7.1
°�o
94-1 � *.
_
94 -46B - - 3