HomeMy WebLinkAboutCLE200800133 Legacy Document 2013-01-17Application for Zoning Clearance
CLE # � 06 I _ S
PARCEL INFORMATION / p�
Tax Map and Parcel: C) �T F f ^ (Do "' Do Da O ct,:" Existing Zoning f) i
Parcel Owner: S ywP E^ Q� u W oe_� I prw o L b C--
Parcel Address: 3,3 S ELqZ It! a-j. ti City r _11(-e_ _ State 11 IA- Zip 2LDAc53
(include suite or floor)
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PRIMARY CONTACT
Who should we call /write concerning this project?
Address : ,3�5 i-i [ (�� we�c�oC �-a� City }� i LU State i/9� -- Zip �i 'k
Office Phone: ( c'( } 1 �I Cell # C�;"q VAC'l Fax # E -mail
APPLICANT INFORMATION /
Business Name /Type: m EQ f C- R-Z-At� EP ,`1J �i � (
Previous Business on this site NON f— KF-�-
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: "FA 14-c! c CC`i' Lc,,e C
*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 I will abide by them.
Signature
.site plan..
] This site complies with the site plan as of this date.
Notes:
Printed C TO t'Lry 1) - 1 �a ( Cq C.
ompliance with the existing
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
n t
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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.
W/N
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 or, Rigc Ovate ?
If private well, provide 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 septic or public sewer?
Y/N
ill you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #4 ` j18
J/ N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #:2 r3oq— OOS(53AC-
Zoning to complete the following:
Reviewer to complete the following:
Square footage of Use:
On'i'tted as: 4ekh (i 5k kmey
Under Section:
Supplementary reg lations section:
Parking formula: j
`�" ?P lVW, (P.vt-�
Required spa I ,�
l'lOT�lNS a�t,La Ve✓� wn 5% h ��
Y/N
Items to be verified in the field:
Inspector : Date:
Notes:
Violations:
Ifs Qst:
if
Proffers:
/ N
f so, List:
Variance:
Y/
If sst-.
's:
N
f s , List: r i
Clearances:
SDP's
Revised 04/28/08 Page 3 of 3