HomeMy WebLinkAboutCLE201200193 Legacy Document 2013-01-0411;
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Zoning Clearance= $3- 0"?D
OFFICE U Y
Check # A, YOL Date:
PLEASE REVIEW ALL 3 SHEETS
Receipt it Staff:
PARCEL INFORMATION
Tax Map and Parcel: 0 & I W 0 0 1 00 - n QQ Existing Zoning
Parcel Owner: Uvwuit- L-�K D
Parcel Address: .2-1 L I M re-, IG-14 A&Ag== jWity Cii-,41z tC)TTISMU&ate zip -2 290
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? -C-Aj�A-
Address 1'rS1AJLCA+ anL*cz: CityCH94 &u--L-MJ (1,t State Zip Zi 90J
Office Phone:) J13- �14 1 Cell Y-T-6� Fax # (773-0132- E-mail
APPLICANT INFORMATION
Check'any that apply: Change of ownership Change of use Change of name 100 New business
Business Name/Type: Ar :VE2 L--n 0
— -,CAA-A--V&
Previous Business on this site SoLrr—t+ tz- gA A i tz--
Describe the proposed business including use, number of employees, number of shifts, available i)arldna, spaces, number of
vehicles, and any additional information that you can provide: A6 A!TC144 L- C41- 1?
k4- Cob&VAW! Ylr-�IIL4Q3 WL,12i� 53 A�JAILA� — VI-Al 1 S?Ufi
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 luiowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed
APPROVAL IN-FORMATION
Approved as proposed Approved with conditions Denied
Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, x117.
] 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�c tt),-
Zoning Official Date ::I- dl
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, 10/13/09 Pace 2 of 3
111
i5
I:atc3l .— tD � A A to Zrlie ..,ia�3w fib:
Y /C
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y
Will there 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 o ublic water?
If private well, provide Hea epartment four.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applie
Is parcel on septic or
ublic sewer?
,V/ N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit # ` 'CHpi.► ,► AROL[G!
Y--/ N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit r 13 2 e 12_ — 01 2-,0 g,_ kc
Zoning to cornplete the following:
Square rootage or Use: 11 2 J
LY �
Permitted as: c'i1"r� ►I
Under Section:
Supplementary regulations section:
Parking formula:
Required spaces:
Y/
Items to be verified in the field:
Inspector : Date;
Notes:
Violations:
Y /ICY)
If so, L-fst:
Proffers:
Y /(' -
If so; 2 ist:
Variance:
IfS/o, ii
If so, ist:
SP's:
Y /c�
If so, rst:
Clearances:
SDP's
Revised 04/28/08, 10/13/09 Page 3 of 3
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