HomeMy WebLinkAboutCLE201200031 Review Comments Zoning Clearance 2012-02-29Q�(v
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Application for Zoning Clearance -
CLE# a t_N
r
OFFICE USE QNLY
PLEASE REVIEW ALL 3 SHEETS
Check # Date: i
Receipt # Staff:
PARCEL INFORMATION 6 -�-
Tax Map and Parcelqq 1-e a Pa o,4 e t Existing Zoning ,C naQy 1 �o• n�
Parcel Owner:
Parcel Address:—:,5,i ai 3 zx r. Pe, A),t ,4 R.J City C Me 'f- State V1+ Zip ZZ93
(include suite or floor)
PRIMARY CONTACT
/ i /�
Who should we call/write concerning this project? h � 4& K t.. 1% 7NPt
Address: �`[� {►C2 Al f�6C col City C. rp t State y/f Zip 22 2
Al
Office Phone: C-1)!!J) fZ3 ^4-4 GL Cell # Fax # E -mail swe, r� 11AP �Cgv tK
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name /Type: W ks wtdNLT "6t1 Age 92* W � VAX-- f s
1
Previous Business on this site « �•.q q.rp ... Gi.ed11 O (r�i NN !AbG 2 Vbhb t'S -tire ►-e
Describe the proposed business including use, number of employees, number of shifts, available parking s aces, number of
vehicles, and any additional information that you can provide: v
4--4 ,
*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 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 Printed z���1
AP OVAL INFORMATION
[k/Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] ckflow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, x117.
[ No nr sical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing
site p' :..
i his site complies with the site plan as of t 's date.
Notes Q
Building Official Date
Zoning Official Date.;
—Ara - b -
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
.GeM4
Intake to complete the following:
Y/N
s use in LI, or PDIP zoning? If so, give applicant a Certified
Engineers gpo port packet.
Y /
Will re 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 o ublic water?
If private well, provide Heat en form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one hat-a plies
Is parcel o septic public sewer?
Y /
Wil oii be putting up anew sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y /
Will ere 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: 185's
(1/ N fn (`�
Permitted as: r}�Q..0 1�1(.'f (1(-fi )f IY lc
Under Section: i!
Su i n tary regulatiops section:
fMA 0,09 C-fitnlrl V-A r' " 114
Parking olrm a: I �(� QUA aren
e-j a
Required spaces: i
Y/N
Items to be verified in the field:
Inspector:
Notes:
Date:
Viol o s:
If/
Ifs st:
Pro
Y N
If so, ist:
Variance:
Y/N
If so, List:
SP's
Y/
If so, ist:
ell
Clearances:
SDP's
Ito
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Revised 7/1/2011 Page 3 of 3
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THIS IS TO CERTIFY THAT ON 007'0BE'/P Z8 / /383 I SURVEYED THE PROPERTY SHOWN ON
THIS PLAT AND THAT THE TITLE LINES AND WALLS OF THE BUILDINGS ARE SHOWN H REON.
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CIVIL ENGINEERING - LAND SURVEYING - LAND PLANNING
CHARLOTTESVILLE, VIRGINIA
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