The URL can be used to link to this page

Home My WebLink AboutCLE200900073 Legacy Document 2012-08-30Application for Zoning Clearance CLE # W-93 ~ �IRf;IN \P OFFICE U I Y ❑ Zoning Clearance = $35 Check # Date: PLEASE REVIEW ALL 3 SHEETS Receipt #d— "aft. PARCEL INFORMATION Parcel: CJ — Existing Zoning Tax Map and Parcel Owner: 40,1 10TAIC C C&I't 65 S5QCIA L _- C & S' l-1,121") oweli Parcel Address: / i yC) C - /� To 9:5> City C %'t� State (1 CI Zip (include suite or floor) PRIMARY CONTACT �I/� %� Who should we call /write concerning this project? Address: /� 60b DG- N ryatIA % `City lj %A/✓�S51 State [,IX . Zip 2014 Office Phone: 45 �-J u i� Cell # >"��5"�r'i %Fax # E -mail 1�c� .S�/�' %i-. f� /ti APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business >> Business Name /Type: - 7 e YnJ"+ 1 S L' / f -r of F L.. y i f K .S 5 %i Previous Business on this site cv, & /Li l4 // /-''� ii' f 27 N 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: "T� /`�P I= �if'�c✓ ; /? d�5 5 i� L f✓ i 2 t"/�9 F't c- 4/ EIS . I n "7 S G f= ='!-J: �y i- *This Clearance will only be valid on the parcel for which it is approved. If you change, intensify or move the use to anew location, anew 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 yo s e-?O f / tl-,5 L LS APPROVAL INFORMATION [ ] Approved as proposed [ ] Approved with conditions [ ] Denied [ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, x119. [ ] 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 ' If � Y i AA Building Official Date_ 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 Page 2 of 3 w, GLu `l.. Intake to complete the following: Y /(NJ Is us n LI, HI or PDIP zoning? Engineer's Report (CER) packet. If so, give applicant a Certified Y / Will ere 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 Reviewer to complete th following: Square footage of Use: d V1 N Permitted as: i,,//YoSo ��iifC yGIJ� Under Section: �r1wi, �Yvi Supplementary regulations section: n��A Circle the one that applies Parking formula: Is parcel on private well ater? If private well, provide Health Depa ient form. Zoning review can not begyunaceiv, r approval from Health Required spaces: Dept. FAX DATE kl~5�� ✓l d-,' Y/N Circle the one that applies Items to be verified in t i d: Is parcel on septic or publ Y/N Will you be putting up a new sign of any 1d d? If so, obtain proper Sign pe Permit # - ' Inspector : Date: Y/N Will there be any new construction or If so, obtain the proper Permit. Permit # Zonine to complete the followinLy: 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 I� Applicati ®n f ®r Zoning Clearance JCLE #W93 ''rye ��Rr,IN�P ❑ Zoning Clearance = $35" OFFICE Uy � �Y Check # e Date: PLEASE REVIEW ALL 3 SHEETS Receipt # "Aq.n Staff: PARCEL INFORMATION 6,-/ Tax Map and Parcel: rJ J — Existing Zoning Parcel Owner: S 14,D ve, -z-N C7/V rtr ... -,- A� S dy`7 A' Parcel Address: 6<o() ' \ U0 �C) City L �J State IJ 'f - Zip (include suite or floor) P ' MARY CONTACT o should we call /write concerning this project? Address P/// C �' -� t L'y l City j�'J /�^rs s� 5 State f✓/ Zip Office Phone: 7c 7 7 > -' S u If Cell # ;P55 72i —S �l /Fax # E -mail I//v APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business Name /Type: 3-. -6 : C /V �r _-.S C ✓rt"�r,' ; G- 01 L K S S ,l !- & _!� Previous Business on this site i�4 S 1-t 'Tojt, —S c� J) l!z� '6� l"f vF4 /I x- r,,- .. ly 6 Describe the proposed business including use, number of employees, number of shifts, available parldng spaces, number of vehicles, and any additional information that you can provide: f'JLl PiL o V rr S *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. Z �.!�� r G P r' f}--, P'1 i& L /,' H Signature i/t^,� -/ Printed 1 ' APPROVAL INFORMATION [ ] Approved as proposed [ ] Approved with conditions [ ] Denied [ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, x119. [ ] 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: Building Official Y Date Zoning Official Date f'ficial �� f ekL, 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