HomeMy WebLinkAboutCLE201200142 Legacy Document 2012-07-107 a .
CLE t 1612, - i'
a �-
ri�\yyl A
Zoning Clearance = $35
OFFICE S Ol Y Y
Check # Date:
PLEASE REVIEW ALL 3 SHEETS
Receipt'- Staff:
%J L41
PARCEL INFORMATION
Tax Map and Parcel: 060 1 KIQ — d l - O A ^ Q Q Ec7O�f --? /Vxisting Zoning &lL-HaoK•N MODS`
N &A, 1D
Parcel Owner:_Abjo. r LAJ.LDT'f_051—
Parcel. Address: 3LIC Vil, City C ,X State VA Zip ;829a!
.
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? SWELL A. LlLQ f;.E C{-t
Address: 25'.5' J f Jd 1 e_&.i City C 14- A9;3E0Lr_zA ffSiate VA Zip Z Z90
OfiicePhone: 973 -6141 Cell r..YJyL:j 2V T%I -a=E -mail V 1
APPLICANT INFOR —AJION
Check any that apply: Change of ownership Chance of use Change of name New business
Business Name /Type: M,A< 1. AUX, 'i CQMUVAi l.j l LL G
Previous Business on this site t 1. DQ :Q p '- 1"'0 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: �,1♦.14006UP P t9Tttli2 j'� 1 O j� lM/�D0"Kj fZ,i'
Ug F' S Iw!< yn4 2 uffl (Sne� _ 1 �- W_4& g -5 .C2 JCL) JXA- marl✓ IW o L)KI C-51 -CO
7CLh &A \Md i 124)L-7 A&0JJ 'FM 047 <40 C 0)„ -ta y
This Clearance will only be valid on tiie parcel for which it is approved. Ifyou change, intensify or nl of the use to a new location, a new Zoning
Clearance will be required.
I hereby certify that I own or have the ovmer' permission to use the space indicated on this application. I also certify that the information provided
is true and accur to the b, st . ry kllowl dne. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Id Printed SV% A. tALj'�I�.,9_rr Q -rr-
P OVAL 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: ZAN %U-06 CpL1LiT1icWct) (►l n Cody of a,o�jiawn -ot"
Building Official Date err
Zoning Official Date
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 04/28/08, 10/13/09 Page 2 of 3
2
y.
r Al2..°17.Ai.i G.'l3 L'iiifl Aa. a.'G Zile 10: 10°/'i AIA�:
r
Y/�
Is use m LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y /,/IT
Wil 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 o public rvater9
If private well, provide Heath Department form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that ap
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. NOT `C�^C P> -MIL M141cp
Permit
Y/N
Wil sere be any new constriction or renovations?
If so, obtain the proper Permit.
Permit I
Zoning to complete the foliowiny:
� '� TO -i� l_. —_ �` Vii_ —• _ _- _ _
i•-Yi u.1 cl d U)Ukzj lete x`Uazlll AA :
'6t e°rs:
Y/N
If so, List:
Of
Z' A A
Square footage of Use:
qqLMi `8 rY�
Q / Nmitted
as:
Under Sections (0A.(Q• 6L
Supplementary regulations section:
Parking formula:
Required spaces:
Y/N
Items to be verified in the field:
Violations:
Y/N
If so, List:
'6t e°rs:
Y/N
If so, List:
Of
Z' A A
� —
a011-06
Variance:
YI'N
If so, List:
SP's:
Y/N
If so, List:
r C,�
K [A—
Clearances:
0%11_1q3 Y. &��t
SDP's
Revised 04/28/08, 10/13/09 Page 3 of 3
wW)
711,
I
I