HomeMy WebLinkAboutCLE200900004 Legacy Document 2012-08-22Application for Zoning Clearance°
CLE # k)q - L�
[Zoning Clearance = $35
OFFICE USE ON4 �
Check # Date:
PLEASE REVIEW ALL,3 SHEETS
Receipt # '7� U Staff:
PARCEL INFORMATION
Tax Map and Parcel: 1010 0 - 0 0 - 0 0 - 0 5 6AO Existing Zoning RA
ParcelOwner• . Albemarle- County Schools
Parcel Address: 4217 Red Hill Rd City Charlottesville State VA Zip 22903
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? Ruth Stornetta
Address -307 C 2nd St NW Citv'Charlottesville State VA Zip 22902
Office Phone: �� 982 -3977 Cell# 242 -3144 Fax #982-3878 E -mail rS3j @virginia.edu
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
BusinessName/Type: Monticello Velo Club /non - profit bicycle club
Previous Business on this siteT — N/ w1 ► dr jl/�t d o� �j� u 0� . �' ��P�yyw 4ij/cQ2t
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[ royide: Bicycle race registration and
parking on - Mareh—� L -v 0 � V' 6:1q( +
motrck L 1 zoo I
*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 knowledg . I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed Ruth Stornetta
APPROVAL INFORMATION
[ ] Approved as proposed [ pproved with conditions [ ] Denied
[ ] Bac w prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, xl 19.
[ ANo physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing
site plan.
[ ] This to complies with the site plan as of this date. . 1
W
Na tes: U0 &P W W [ VO 6T ,�} <, t>p 1-f- rCG ui ad ► & G�46YI -5
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Building Official Date i
Zoning Official Date 2,
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 Page 2 of 3
Intake to complete the following:
Y a /�
Is I, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Yalc
be food preparation?
If so, give applicant a Health Department foils.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one tl ypl es
Is parcel on pr ate w 1 or public water?
If private well r de Health Department form.
Zoning review can not begun until we receive approval from Health
Dept. FAX DATE
Circle the one ti2a applies
Is parcel on i or public sewer?
Y/N
Will you be puttin up a new sign of any land? If so, obtain proper
Sign permit.
Permit #
Y/N
Will there be any i Ow construction or renovations?
If so, obtain the pr per Permit.
Permit #
Zoning to comDlete the followine:
Reviewer to complete the following:
Square footage of Use: N A- .
fl N — itsL,G�_
ermitted as:
Under Section: I0. 1• 1
Supplementary regulati ns section:
iti .%
Parking fOrML11a: I
Required spaces:
pl- it'/rJ
Y/N
Items to be verified in the field:
Inspector : Date:
Notes:
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 04/28/08 Page 3 of 3