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HomeMy WebLinkAboutCLE200800052 Legacy Document 2013-01-11L� i / Application for Zoning Clearance pF Rf, /W, County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 5/l/06 Page 2 of 3 om ce Dr ,ring ** OFFICE USE ONLY ❑ Zoning Clearance = $35 CLE # ,2 d b cy a OjoZ Check # Q I Date: PLEASE REVIEW ALL 3 SHEETS Receipt # k/1-1 t Staff: (EO! PARCEL INFORMATION 09100 -00 -00 -01300 R1 Residential Tax Map and Parcel: Existing Zoning Parcel Owner: County of Albemarle School Board Parcel Address: 1757 Avon Street Extended City CharlottesvillEState VA Zip22902 (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? Rose M. Van Epp Address: 1271 Quail Crossing City CharlottesvilleState VA Zip 22902 Office Phone: L_) 293 -1200 Cell # 962 -1634 Fax # 293 -2135 E -mail StamperRose @embarqmail . APPLICANT INFORMATION Business Name /Type: Paul H. Cale Elementary School - public school Previous Business on this site N/A Describe the proposed business, including use, number of employees, number of shifts, available parking spaces and any additional information that you can provide: A 5 is lanned at Cale lementar choo n Sat rda May 17, 2008. We will use the parking o o a e as e s aging area w ere t e r will egin , we will use the ca eteria tor registration and will use the gymnasium an event for the children - i.e. face painting, etc. We will also use the lower par'. *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 t I own or have the ownees permission to use the space indicated on this application. I also certify that the information provided is true and acc to the best of my wle ge. I ha v ad the conditions of app and I understand them and that I will abide by them. Signature - Printed �Si� --/I to APPROV L INFORMATION [ ] Approved as proposed [ ] Approved with conditions [ ] Denied [ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, x] 19. [ ] 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 c� �-� �-�4 = ° ° 1 Date 3 ti �� EAU ! Zoning Official Date 3Other Official Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 5/l/06 Page 2 of 3 om ce Dr ,ring ** Intake to complete the following: ❑ YES 5/NO Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. ❑ YES �NO 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 ❑ YES ❑ NO Is parcel on private well or lic wa r? If private well, provide He ]th D rtment form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE ❑ YES ❑ NO Is parcel on septic or p - lic sew r? ❑ YES F,/1 NO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑ YES © NO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Zoning Tech to complete the following: Reviewer to complete the following: Square footage of Use: 19 YES ❑ NO Permitted as: / Under Section: Supplementary regguulpt ions section: Parking formula: Required spaces: u YES U/NO Items to be erified in the field: Inspector : Notes: Date: Violations: ❑ YES v / NO If so, List: Proffers: ❑ YES DINO If so, List: Variance: _ YES NO If so,'Lisf: SP's: ❑ YES NO If so, List: 5/1/06 Page 3 of 3