HomeMy WebLinkAboutCLE200900134 Legacy Document 2012-09-10x
.Application % Z,onin Clearance
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Zoning Clearance= $35
PLEA E REVIEW ALL, 3 SHEETS
OFFICE USE ONLY e, 0,09
Check # i3 % 2. Date:
Receipt#
- -
-- Staff:
PARCEL INFORMATION
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Tax Map and Parcel: ('7 -Q( 00 -o t J7 Z Existing Zoning .
Parcel Owner: /A USA
Parcel Address: '{ XVER1-3E/ND > Ic City. '' ' Li. LE State. V
- (include suite or floor) S U iT'G
PRIMARY CONTACT
Who should we call/write concerning this project?, Mhta\4 . i L LI L ll� r� \jAr-r t k j / fl- 1_.+ & jhC_Q
Address: —1)lz City C'Ji i l r State VA Zip22
Office Phone: 66M) 9_ ) Cell #
M'�hN Y e Ceti
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use hange of name New business
Business Name/Type: i 1R CPA_
A
Previous Business on this site _Rly/A-",11%yiA . �•rCAR, iG A ppA ' c
Describe the proposed business including use, number of emp)oyees,.numbet of shifts, available parking spaces, number of
vehicles; and any additional informafion,th ou can provide: U T.!%C1C t
*This Clearance will only be valid:on;the parcel for which it is:approved, .If yo'u change, intensify. or move the use to anew location; a >new Zoning
Clearance will be required.,
1. hereby eeitify that 1 own or haye'the- owner's permissionpto use the space indicated an this application. I also certify that.the i ifohnation provi&d .
is true and accurate to the best of my knowledge: I'have read.the conditions of approval, and.I understand them, and.thatI will abide by them_
Signature . rintei!r/ /�
APPROVAL: INFORMATION
Approved as proposed [ ]:Approved with conditions [ ] Denied
[ I Backtiow prevention .device and/or current test data needed for this.site: Contact ACSA, 977=4511, xl.19.
[ ] No physical site inspection has been done,forthis clearance: Therefore, it'is pot a determination of compliance with the existing
site plan.
[ ] This site complies with "the.site plan as of this date..
Notes:
Building Official Date
:Zoning Official Date
Other Official _ Date:
—unay vi l uGUlne /G tUG ntlLlCrll gl Lommunl[yveveloprnenI-
401 McIntire Road :Charlottesville; VA:22902 Voice 034)'296 -5832 Fax .(434) 972- 4126
Revised 04/28/08 NO 2.60
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Intake to complete the following: Reviewer to complete.the following:
Y /
Is use m LI, HI or PDIP Zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y
WiI_ __-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 nblic water?
If private well, provide en orm:
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one.that a
Is parcel on septi • r public sewer?_---.--
Y 11 N)
Wil ou be;putting up anew sign of any, kind?- If so, obtain proper
Sign permit;
Permit -
Y
Will there be any new construction or renovations?
If so, obtain the proper Penn it.
.Permit 4.
Y'
to complete the
List:
Var' ne!n
Y
If so/, N ist:
Clearances •
� � e
Square fbotage.of Use: vJ
Permitted as;
Under'Section: - Z_ (, 7
Supplementary regulations section:
Parking formula: /-4ouX,
�y
Required spaces;
Y/.
Items o be verified in the field:
Notes:
Y /0.
If so; List:
Y /
If so,, ist:.
Dater -
Revised 04/28/08 Page•3 of