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HomeMy WebLinkAboutCLE200800136 ApplicationApplication for Zoning Clearance ��` °� � CLE # 2W R — /�7D �r i I %RCIN�P ' UFFICE USE )L k, $35 Zoning Clearance # � .64 PLEASE s ' PLEASE REVIEW.ALL 31'SHEETS Receipt'; #. I/ PARCEL INFORMATION Tax Map and Parcel: U — ©o — oc) ogzf AD Existing Zoning, Manned UNdo, �y l C�1-c - Parcel Owner: SEW �� V-1 tk I LL L-L �_ _ C� u -W C� eftTff NAaA(,f_EJ4UMT1 Parcel Address: I_fiSj P-i6 hJ 11 CC&(_I?- City (ha�JftKWIMState VA Zip 7.2g01 (include suite or floor) PRIMARY CONTACT Who should we call /write concerning this project? Ali l n ,1 CA bqt i Address: X002 \iwit F)IVd . Sfi(. PfjZ _City .61tJ�Gfflfia State f zip Office Phone: Z2*Ce1l # �W _TMyC ax # -71D Z25 ZZ E -mail Ai ( MagYZi ► I16 • LovII APPLICANT INFORMATION Business Name /Type: Previous Business on this site L Uvin 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 provider (� (� �,u( ink I V1 'pG1.m U I 0 i 1�nIrn.C.° .Cn-h(oArh,, ' Inman ,— [IMM i — I U {L MV ovv\ 111•^ /11,9 *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 Printed A U U1 Hrl'1KV VHL 11N1' Vnffll'iJ [ ] Approved as proposed . [ ] Backflow prevention device [ ] No,physicaI site inspectton'11, site plan. [ ] This sie c mplies with the st Notes 17.1--Ll, r n'o rh .c1--.,4. Building Official Zoning Official Other Official plan As of this 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 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 eport (CER) packet., Y / (N /, Will ere 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 applis Is parcel on private well e or ublic Water? If private well, provide Health apartment form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one tha pies Is parcel on septic or public sewer. Y N Wi be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Y/N Will ere be any new construction or renovations? If so, obtain the proper Permit. Permit # 7.nnina to rmmnlPtP the fnllnwinu- Reviewer to complete the following: Square footage of Use: Purr - tted as: ,I Under Section: �� U Supplementary regul ions section: 1\1a Parking formula• Required spaces Y/N Items to be verified in the field: Inspector: Date: J414 47"/ Cam- / -- ------ -- - - -- - - - - - - -- - - - - - • - -- Violations: Y / N If so, List: Proffers: Y / If so, st: Variance: Y /N If so, L SP's: Y/N so, List: Clearances: DP' Revised 04/28/08 Page 3 of 3