HomeMy WebLinkAboutCLE200800157 Legacy Document 2013-01-28Application for ��.Zoning Clearance �_���� °�
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PARCEL INFORMATION "
Tax Map and Parcel: 0 61 Y 0 — 0 0 — OB —1010 0 Existing Zoning NMD
Parcel Owner: BFR Pro]2erties,
Unit 01
Parcel Address: 943 Gienwood Station Lfity Char ttesvil&ate VA-!. Zip22901
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? E. Randall Ralston
Address: 1020 Ednam Center Ste 102 City CharlottesvilSLabe VA Zip 22903
Office Phone: (434817 -1040 Cell# Fax# 220 -4894 E -mail err Rrrals .on.rnm
APPLICANT INFORMATION I
Business Name /Type: Re /Max Assured Properties — Retail Sales (Real Estate)
Previous Business on this site
Describe the proposed business including use, number of employees, number of shi gs, available parking spaces, number of
vehicles, and any additi�opal information that you can provide: office s ace- r wt" Y��PC�I � Y
esta ie sa.irs o M. cc ° -I- S enapl e � sip i� �i C S �, - SQ rS -1 U pCCY� I t�G
s :es 6 vcr JQ'e
*This Clearan e 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 hue and accurate to e be t of my iowledge. I have read the conditions of approval, and I; understand
(}them, and thh I will abide by them.
Signature �- i Q lid ,� Printed
€m
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:
Is us) s u LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y /j 1
Wil ere be food preparation?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval fi•om Health
Dept. FAX DATE
Circle the one that applies
Is parcel on private well or p#' ter?
If private well, provide Health qepajVnent form.
Zoning review can not begin until we receive approval fiom Health
Dept. FAX DATE
Circle the one that applie
Is parcel on septic or p lic se er?
Y /�Will be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y /
Wil ere be any new construction or renovations?
If t p gpp Pe
Per mit # � U�Y 1
(,
Zoning to complete the followinL:
Reviewer to complete tlhe following:
Square footage of Use:
�rmi ted as:
Under Section. � &0
Supplementary regulatio Is section:
of
Parking formula: o oe l
Required spaces: r1
Y/N /
Items to be verified in the field:
Inspector : Date:
Notes: 1A , 1<", a 0 C-- �
Violations:
Y/N
If so, List:
offers..
/N
f so,ib,i�t�
Variance:
Y/N
If so, List:
SP's:
Y/N
If so, List:
Clearances:
SDP's
Revised 04/28/08 Page 3 of 3