Loading...
HomeMy WebLinkAboutCLE200800069 Application Zoning Clearance 2008-03-31Application for Zoning Clearance vZoning Clearance = $35 OFFICE USE ONLY CLE # O PLEASE REVIEW ALL 3 SHEETS Check# Date: 3L, / —© Receipt # Staff: PARCEL INFORMATION Tax Map and Parcel: 7 8 -r 1 1 5 Existing Zoning H G Parcel Owner: M O vA-r r-_-5 5 0 V- 1 C DMtint! t4 t'rY�- Parcel Address: I Q & 1 iZt Ctrl A O No 20 . City 6t y t LLe State V A. Zip Z Z 411 (include suite or floor) PRIMARY CONTACT M r`/ � Who should we call/write concerning this project? mysk"_ • QE Fw 2 Gl-► t-t t;= L" I" Address: A* 1 City t ,--L-S State Zip ZZ-505 305 43-A Office Phone: 61A) 2 ctS `7 1 % l Cell # A &,7 • A 0 Z( Fax # zot 5 • SS-3 tP E -mail t-A tz 0a-\ G /-Ut- • C.O wi APPLICANT INFORMATION Business Name /Type: e5 t✓� C) U C, A.-rt O t-4 Jh- t Lf- -r L; ► D tJ Previous Business on this site ,b M t =fit Q L D t-A et O E-► /s L Describe the the proposed business, including use, number of employees, number of shifts, available parking spaces and any additional information that you can provide: tM 0 t4-r t°-SS 0 P.a C.0MMU N t-ry S e.t-to O t.. O W,-+cs �hlalcVµ7 04MCOL_ Art.tp WtQt —t C6 TO AS 4,001-rtOI-I&" G I+AS S 1zmo A M S P A C.> . S r--E w/ TLO N 1--tm t 4 S. *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 knowledge. I have read the conditions of approval, and I understand them, and that Iwill abide by them. Signature a—l� Printed W-ev)d U t1 s AP OVAL INFORMATION [ pproved as proposed [ ] Approved with conditions [ ] Denied [ ] acicflow prevention device and /or current test data needed for this site. Contact ACSA, 977 -4511, x119. 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 th site p an as o this date. • (% Notes: 6t vtM '(b y� vn ��Q (( G�-G�� , Building Official Date Zoning Official Date % a$ Other Official Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 511106 Page 2 of 3 r� Intake to complete he following: F-1 YES O Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CE ) packet. ❑ YES O 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 ublic w er? If private well, provide Hea th D i2 ment form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE ❑ YES ❑ NO Is parcel on septic or • lic se er? ❑ YES M/NO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # / ❑ YES 7 /NO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # LoWnLy Tech to complete the iollowmLy: Viol Lions: [1YES ❑ NO If so, List: C; �R Ab' &4 e A. Variance: ❑ YES ❑d NO If so, List: Reviewer to complete the following: N •j I Square footage of Use: WW ` ©AYES ❑ 1VrW fir, /� n Permitted as: ((jjJJ u�l - ✓r%GL49'� Under Section: V 04 - A . i l $ / _ Supplementary regulations section: Parking formw Q Required spa�:I ❑ YES ❑ mo Items to . e verified in the field: bo,r" 'b� lkj, J a,UW MCLA - cfl 10 tAA , ✓ 1 Inspector : Date: Notes: Proffers: ❑ YES .7, NO If so, List: SP's: ❑ YES 5��NO If so, List: 5/1/06 Page 3 of