HomeMy WebLinkAboutCLE201200150 Legacy Document 2012-10-26._ -- -- -- - -- - .. - -- -...- ----- ....._.._.._. _...._.__ ._- _..__._.._- ._-_._--- -•._ -.._ -- __.._._.._..- -- --- • -- -••- - -- III
Application for nisi Clearance�r,�
CLE it /� J
-
OFFICE USE ON
OI V Date: r
PI,HASER VIE1i�AT�I�3SHEETS
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PA.RCX+L INFORMATION YY
Tax Map and Parcel: TM 61 Existing Zoning I�%��ll'
Parcel O►vner:,
- Psrce!Address:�Q35g4nd hrel. -Suite I to -- City _Chadottesuille -- --State -ya -- Zip- - - °- -
_. ...(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? Melanie Bagley / Noodles & Co,
Address : 2348 Arezzo Lane City Allen State TX Zlp 75013
Office Phone; 9L 7?) 396.8409 Cell tf Fax 9 214 -291 -5597 E -mail mbogley @bunterdevelopmentgroup.
APPLICANT INFORMATION -
Checl( any that apply: Change of owtte.rshlp Change of ttse Change of name X New business
Business Name /Type: Noodles & Company - Restaurant
Previous Business on this site none - new construction
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:
"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, anew Zoning
Clearance will be required,
I hereby certify that I own or have die owners permission to use the space indicated on this application. I also certify that the infon-nallon provided
is true and ut6uraqt, ip,the bes . fmy knowled e..l have read fire conditions ofapproval, and I understand (hem, and that I will abide by them.
r
yy �
Printed Melanie Bggley
APPROVAL INFORMATION
L" Approved as proposed [ )Approved with conditions ( ] Denied
( ] Bach-flow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, x 1 I7.
( ] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the exlsting
site plan.
[ ] This site complies with the site plan as of this dale.
Notes:
Building Official Date -� I f-lt l
Zoning Official Date %Z dZ2��2�
Other Ofiici -! Date 11�'
C:4anty nr At4emarle Ueparrmenr or i-ommurury Uevemproenr
401 hiantire Road Charlottesville, VA 22902 Voice: (434) 296•5632 Fax: (434) 972.4126
Revised 7/112011 Page 2 of 3
>m
Intake to complete the following:
Reviewer to complete the
Y ILI,
pfollowing:
Square footage of Use: / 7J
Is HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
QY / N /
Permitted as: gQ SW-4
.ill there. be food preparation? _ _ _
Under Section: _ /�/ � �� e-• (�
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE ?/
Supplementary regulations section:
Circle the one that applies
Parking formula: f, 5
Is parcel on private well or public wat�r�
/�
If private well, provide Heal h Department form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Required spaces: 1-3
Y/
Circle the one that applies
Items to be verified in the field:
Is parcel on septic or pu lic sewer?
l N
SDP's
i/
1 i1 you be putting up a new sign of any kind? If so, obtain proper
- - _
- - -
Sign permit.
Permit #
Inspector : Date:
( N
211 /there
Notes:
be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Vj / n
UC
Zoning to comDlete the followinLY:
Violations:
Y/
If so, List:
P offers:
/N
If so, List:
Varia ce:
Y/
If so, List:
S 's:
/N
If so, List:
95—s
Clearances:
SDP's
Revised 7/1/2011 Page 3 of 3
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the
.owner_. _.
I certify that notice of the application, Zoning Clearance Application
ALL=' /00
[County application name and number]
was - provided to - Dave - Faso -/ - Edens - &- Avant— - the owner of-record-of -Tax -Map
[name(s) of the record owners of the parcel]
and Parcel Number TM61 by delivering a copy of the application in the
manner identified below:
Hand delivering a copy of the application to
[Name of the record owner if the record owner is a
person; if the -owner of record is an entity; identify the recipient of the record and the recipient's - -
title or office for that entity]
on
Date
X Mailing a copy of the application to Dave Faso / Edens & Avant
[Name of the record owner if the record owner is a person;
if the owner of record is an entity, identify the recipient of the record and the recipient's title or
office for that entity]
on 9 July 2012 to the following address:
Date
7200 Wisconsin Avenue, Suite 400; Bethesda, MD 20814
[address; written notice mailed to the owner at the last known address of the owner as shown on
the current real estate tax assessment books or current real estate tax assessment records satisfies
this requirement].
Digitally signed by Melissa McPherson
Melissa { DN: cn= Melissa McPherson, o, ou,
t \ email= mmcpherson @hunterdevelopme
f tc ou P.com, rUS
igriature o pplicar t Date: 2012.07.0916:45:31 - 05'00'
Melissa McPherson
Print Applicant Name
9 July 2012
Date