Loading...
HomeMy WebLinkAboutCLE200800229 Legacy Document 2013-03-18Application for Zoning Clearance OFFICE USE ON oning Clearance = $35 CLE # 2 � PLEASE REVIEW ALL 3 SHEETS Check # Date: + , Receipt # Staff: PARCEL INFORMATION Tax Map and Parcel: Parcel Owner: 0©6o ©C o 1- P rz) pw'rh e�s C►519g6) Existing Zoning , -} G pF 11./7. Parcel Address:_ _ 1'" b 1 '7 I (� 0 CityC�,r lbf)t_' 5\ J C State i n Zip (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? iY-) C --L Address : PC) G� -76al City l hq r-10t t5Ult1�ate WCy Zip q%LP Office Phone: "" 1 a'aofti&# Fax # q3q- aa6_861 y E -mail '4-1t 4d& C0t6n 1CJ M ,Cd& ORO - ,306 APPLICANT INFORMATION Business Name/Type: Cb�c)Y- 6 (aA Previous Business on this Describe the proposed business, including use, number of employees, number of shifts, avaH bl parking spaces and any additional information that you can provide: t7 u { �- l Sh C `` t 'This Clearance will only be valid on the parcel for which it is approved. If u c ge, intensify or move the use to a new loca 'on, a new Zoning Clearance will be required I hereby c�that I own or have the owner's permission to use the space indicated on this a at the information provided is true an act to to ttXbest of my kpowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signal it e ti Printed APPROVAL INFORMATION [ ] Approved as proposed [ roved with conditions [ ] Denied [ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 9774511, 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 s}'� comV1'es with the site plan as of this date_ Notes: -HO r -17A D .���5 A 1+ nt ri — t? / d in I,- /iA Building Official Date >� Zoning Official Date g Other Official Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 9724126 5/1/06 Page 2 of 3 3 f [ n Zoninjj Tech to complete the following: Violations: Proffers: ❑ YES Z NO ❑ YES NO If so, List: If so, List: Variance: SP's: YES- NO If so, List: J If so, List: 511106 Page 3 of 3 Intake to complete the following: Reviewer to complete the following: j - -- - -- Y-ES --' �-ONr O— - -- - – - -..._ - - -- ❑ A - Square footage- ofUse: %T'--- - - - -__ ----- - - - - -- __ _ Is use in LI, PDI P zoning? If so, give applicant a Certified Engineer's Report (CER) packet ❑ YES NO Will there f preparation? MMES ❑ N Permitted as: t� Under Section: d-•' If so, give applicant a Health Department form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Supplementary regulations ection: i b Gj Parking formula: ❑ YES NO Is parcel o pn ate well or public water? I Required spaces: If private well, provide Health Department form Zoning review can not begin until we receive approval from Health Dept. FAX DATE YES ❑ NO ❑ YES ❑ NO Items to be verified in the fi pld: Is parcel on septic or public sewer? YES ❑ NO Wil you be putting up anew sign of any kind? If so, obtain proper Sign permit. Permit # Inspector • Date: ❑ YES [O Will there be any new construction or renovations? Notes: If so, obtain the proper Permit. Permit # Zoninjj Tech to complete the following: Violations: Proffers: ❑ YES Z NO ❑ YES NO If so, List: If so, List: Variance: SP's: YES- NO If so, List: J If so, List: 511106 Page 3 of 3