HomeMy WebLinkAboutCLE200800126 Legacy Document 2013-01-17,„' IIJza
Application for Zoning Clearance
CLE
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OFFICE.USE ONLY
:IZonin'g Clearance '$35 check # S �' FDate
"EA
SE, >Receipt# �7„ 1G%�"' °Staff
PARCEL INFOR TON
Tax Map and Parcel: ;9A Existing Zonin
Parcel Owner: 15h bXk L.L.C:_
Parcel Address: W3 B Ru- f l lcy t' Larvz City 'llai✓ ICALSri(Lb State VA Zip x`11 I
(include suite or fl r)
PRIMARY CONTACT
Who should we call /write concerning this project? Lack -re, C-1(LLo
:`Address: 004 gllarmo tA)o ds br City 1%y V- U11 (01 State VA Zipa ,5 oS-S,
Office Phone: L_) Cell Fax # E -mail rgoA(aSS ts�- uhm , COm
APPLICANT INFORMATION I
Business Name/Type: w ury-JA an-kV
Previous Business on this site V1. hAc
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: rwndbQU *W-CLO C - 1 -4 CM 00499LA " t QUe. ('loht�y
dwcj . _ k6 (i. ad(A(Dlc t1QALYa 5005 Ryr bLu,tc rock , I Nut 1 V-6i lk
*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' .underst/an; d them, and that I will abide by them.
Signature C� 1, ��� �➢14 tilC�4 t: Printed Lcxy G� t� t 25
site:plai':
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 Page 2 of 3
Intake to complete the following:
Y/N
Is use in 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 or p (nntil i ?
If private well, provide Healt epartment form.
Zoning review can not begin we receive approval from Health
Dept. FAX DATE
Circle the one that apCbl Is parce l on septic or ewer
Y
WiR-you b ut ting up a new sign of any kind? If so, obtain proper
e P
Sign permit.
Permit #
Willlbe any new construction or renovations?
If so, obtain the proper Permit.
Permit #
7nninv to emmnle.te the fnilnwinu:
Reviewer to complete the following:
Square footage of Use: 02,q
/ N
ermitted as:
Under Section:
Supplementary regulagons section:
Parking fo ltla o orb k$"t
Required aces: j r` / - „l
Y / N `t7C
Items to be verified in the.field:
Viola'Qns:
Y / (jhI/
If so, ist:
Pro s:
1' /
If so, ist:
Vari e:
Y /(
If so, is, t:
P's:
/N
f so; 'st- .-- 4
Clearances:.
SDP's
Revised 04/28/08 Page 3 of 3
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