HomeMy WebLinkAboutCLE201300097 Legacy Document 2013-05-20% J_
Application four} Zoning Clearance
is
PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY 1�
Cheek ;q Date:
,tsc
Receipt # C Staff:
PARCEL INFORMATION ,�
Tax Map and Parcel.: 06110- D3- Qo - Uc> 2. u a Existing Zoning 6_!.. 60mylxen �� t
Parcel Owner: T3 0L�5)
Parcel Address, S 7'r- City Lam` U -1 u State (..14 .
(include suite or floor)
PRIMARY CONTACT
� y,'`'� � b-�.A frr"— tic ``+ "
Who should we call/write concernin g this project?
P } 7
Address: aj. City. I& J"4' c �£ State U 6L Zip Z 2
Office Phone: i {Ll) Q'l'? -31"1 t Celt Fax -# F mafl In i k, h- -1 aS , i t°
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name/Type:tti rRiJ�,.,ti �;� n. 5i•� t'i -�'t IQ-e�+ iCS'`�
Previous Business on this site
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..
*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 orhave the owner's permission to use the space indicated ou this application. I also certify that the information provided
is true and accuraix tow best ofmy lmowledge.I have read the conditions ofapproval, and I uudcm=d them, and that lwlll abide by them.
Signature
APPROVAL ]NFORMA.TION
[ j Approved as proposed [ ] Approved with conditions ( j Denied
[ j Backflow prevention device and/or current test data needed for this site, Contact ACSA, 977 -4511, x117.
No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with. the existing
site plan.
j j This site complies with the site plan as ofthis date.
Notes:
Building Official Date t t 3
Zoning Official Date.. /�%��/�
Other Official -DI ate.
-` S t
County or Albemarle Department of Lommunrty .ueveropmenc
401 McIntire Road Charlottesville, YA 22902 Voice: (434) 296 -5832 Fax: (434)9724126
Revised 7/11201 l Page 2 of 3
Intake to complete the following:
Y /t�
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y /
Will iii 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 applies
is parcel on private well a public w er?
If private well, provide Hea h DeparAent form.
Zoning review can not begin un Tiwte receive approval from Health
Dept, FAX DATE
Reviewer to complete the Following;
Square footage of Use:
4/N
Permitted as: 44z x-W Under Section: Section: :Rt'qe-,4
Supplementary regulations section:
Parking formula:
Required spaces:
Y/N
Circle the one that app * Items to be verified in the field:
Is parcel on septic or ublic er?
Y/N
Will you be putting up a new sign of any kind? Ifso, obtain proper
Sign permit, Inspectors Date:
Permit #
Notes:
Y/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning to Com lele Me Iollvwirt
ations:
I/Nr
f so, List.
Prof rs:
Y/N
If so, ist.
Variance:
Y/N
If so, List:
/N
It so, List:
6 2d
Clearances:
SDP's
L
C.
Revised 7/1/2011 Page 3 of'3
4
C.ERTiI+'ICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PRO'V'IDED TO THE LANDOWNER
This form must accompany zoning applications (Home Occupation, .Zoning Clearance, Zoning
Administrator Determinations or Appeals, ,Sign Permits, Building Permits). if the applicationn is not the
owner.
I certify that notice of the application, -2.-3 — r e &A,
[County 4lication name and number]
was provided to (30 to a -" u V the owner of record of Tax Map
[name(s) of the record, ovmers ofthe parcel]
and Parcel Number O „ 110 - 03 ° 0 y' 00 "Loo by delivering a copy of the application in the
manner identified below:
Hand delivering a copy of the application to
.[Name oft}ae record owner if the record owner is a.
person; if-the owner of record is an entity, identify the recipient of the record and the recipient's
title or office for that entity]
on
Date
X Mailing a copy of the application to v =- e 1-, S { . LL. C—
[Name of the record owner if the record owner is a person;
if the owner of record is an entity, identify the recipient of the record and the recipient's title or
office for that entity]
on S-9-1's to the following address:
Date
'-y- kc r,r-► r r'h-> , l G tw 7-2-cj
[address; written notice mailed to the owner at the last known. address of the owner as shown on
the current real estate tax assessment books or current real estate tax assessment records satisfies
this requirement].
C`
Signature of Applicant
/-, -Q.*— S1,
Print Applicant Name
5" - -6' 13
Date
r
fi
G
-r�
G
Rebecca Morris - Fire Rescue
From: Shawn Maddox
Sent: Wednesday, May 15, 2013 5:23 PM
To Rebecca Morris - Fire Rescue
Subject: RE: your approval for 3 clearances is needed
All three are approved since they are to be permitted by our office.
Shawn
From: Rebecca Morris - Fire Rescue
Sent: Wed 5/1512013 11:54 AM
To: Shawn Maddox
Subject: your approval for 3 clearances is needed
FM Maddox,
Please approve/disapprove and comment regarding attached the 3 Zoning Clearance Applications by way of email to me. I will
sign and attach your response to the application and return it to Community Development in your absence.
As information, I've already spoken with Linda Shiffiett as well. We've scheduled her Fireworks Retail Permit (inspection) with you
for 06/27/2013 at I PM beginning first at 260 Pantops Center, followed by the two locations on Seminole Trail. She's going to
submit to us the usual paperwork as soon as it's completed (property owner permission, list of fireworks to be sold, copy of
insurance). She's had the same permits at these locations for the past several years. She is using a pop-up canopy, not a tent.
Thank you,
Rebecca Morris
Fire Rescue Department
Extension 3101