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Home My WebLink AboutCLE201200238 Legacy Document 2012-11-28Application far Zon Clearance CLE # ,L 12 ' Z.Lj ; OFFICE USE ONLY PLEASE REVIEW ALL 3 SHEETS Check # D Receipt # Staff: PARCEL INFORMATION Tax Map and Parcel: () S'6 jl - 0 I -dd — p^tcicM Existing Zoning Parcel Owner: C 2.e 2 t; ' ( nla ," ;A(5 Parcel Address: S73 i '7"i+ NC ^%-W "A 2p City C-40 2.-V 7 State L/A Zip aL TL (include suite or floor) PRIMARY CONTACT Who should we call /write concerning this project? 2.r8 L-" Ac-ro_s Address:_ 321- 1%P LA-It 9.i 0r/2 City C if ✓ t �-L State LJ'Ay- .� Q' Zip�Z.� 11 Office Phone: (g3j)2% `5`31 Celt # Fax # E-mail P,W AL—rc& f APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business Name/Type: 1 lfi Previous Business on this site 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 oply 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 accu a 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 �- "``� -Jt l � Printed_ iL'5 1.7 i //4-t-r'G* Aj APPROVAL INFORMATION 'Approved as proposed ) Approved with conditions [ ] Denied [ j BackfIow prevention device and/or current test data needed for this site, Contact ACSA, 977 -4511, xl 17 j 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 Date t t J t t Zoning Official Date `°��Z�% 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 7/1/201.1 Page 2 of 3 Intake to complete the following: Y / Is use LI, HI•or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y / Will 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 ater? If private well, provide H alth Depa ment form. Zoning review can not begs e receive approval from Health Dept. FAX DATE Circle the one that applies Is parcel on septic o u is sewe ? YIN Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # YIN Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Zonin to com lete the following: Reviewer to complete the following: Square footage of Use: lN J % ermitted as: 4 Under Section: AV m 4 n ✓/9C� �Sei Supplementary regulations section: Parking formula: Required spaces: YIN Items to be verified in the field: Inspector: Notes: Date: Violations: M1 N f so, List: � � F�P � Proffers: Y 1(5 �If so, List: Variance: YIN If so, List: SP's: Z' /� If so, ist: 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 (Florae Occupation, Zoning Clearance, Zoning Administrator Determuirrtions or Appe(tls, Sign Permits, Building Permits) if the application is not the owner. I certify that notice of the application, [County application name and number] _ I,i was provided to C� z-u 7 �i i 'y5 Q1\( L the owner of record of Tax Map [name(s) of the record owners of the parcel] and Parcel Number 0 5C A- 2- — a,( — CC) e'_ °IOUby 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 t% Mailing a copy of the application to - itclI- t G +J,'r t',V�q Curv`rL -71� [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 lJ Pd "i weA-kv to the following address: Date [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]. Signature of Applicant Print Applicant Name ll- Date e;lecwdAppWcadcoii Number J.j, •,, TMEPeil 056A2 -01 -00 -02900 Own r,J9)r.jCROZET SHOPPING CENTER LLC CROZET VA A,pr oa +.ion Number � TMP is Inactive? ACTIVE I wn own Lr oze Tax Map Parcel Zip 122932 House N 5764: Street Name Apartment/ ..... .............................. UNIT ... ..............................: THREE NOTCH'D RD ..............................< .. ............................... 5760: ................................................................................. THREE NOTCH'D RD ..............................< ..... ..............................: .. ............................... .. ............................... 5752: ................................................................................. THREE NOTCH'D RD BOY SCdt"t-'6Pt)4M 2ND SIGN FOR 2011 SIGN UP: 12/10/2011 - 12/24/2011 Entered By /Date Entered Selected Application Number I CLE201100195 (1— + —f Tina Name I Address Owner /Applicant CROZET SHOPPING CENTER LLC ............................. ............................... a ............................................................. ............................... Primary Contact ROBERT WALTERS City / State ICROZET VA Phone # (I ) - E -mail Entered By Jennifer Durrer NO CONTRACTOR SELECTED P 0 BOX 129 ............................ ............................... 401 MCINTIRE ROAD Zip Code 22932 Fax # r Cellular # I Date Entered 11/09/2011 Type Sub Applicatio Status DateStatus Under Review 11/09/2011 s V: YHIY�t !Nei+'tW_1L4JkVJ_K4WlNH,tWkH'.. 111L'itiVS':+ti:......:i..... ESL'+': �;`4.ZYfV,� yiiN:i'aMFtSl:YtbY:Y:ttl Entered 0XP12 .Yac a,k r. n A i, i 1,7 2d Entered By /Date „r,•, , By /Date erti, . ...�.+� .0�/f , Comments Comments Selected Application Number I CLE201100195 (1— + —f Tina Name I Address Owner /Applicant CROZET SHOPPING CENTER LLC ............................. ............................... a ............................................................. ............................... Primary Contact ROBERT WALTERS City / State ICROZET VA Phone # (I ) - E -mail Entered By Jennifer Durrer NO CONTRACTOR SELECTED P 0 BOX 129 ............................ ............................... 401 MCINTIRE ROAD Zip Code 22932 Fax # r Cellular # I Date Entered 11/09/2011