HomeMy WebLinkAboutCLE201300092 Legacy Document 2013-05-29r
r
Application for Zoning Clearance
��
s
ILL
OFFICE USE ONLY
PLEASE REVIEVV ALL 3 SHEETS
Check # Date;
Receipt # Stn ff:
PARCEL LNFOR1ViATIO�i 44 �
Tax M p iiand Parcel: 0( 1 W0Q< QA. 00-200 Existing Zoning
Parcel Owner: etj IfrIe'N
Parcel Address:_ 11 4?S fyM tKVOCE_ Tie City 044240.' (S 4'11C State VA Zip 421D
(include suite of Hoax) t , ,��� If •
PRIMARY CONTACT
Who should we call/write concerning this project?
Address : (5'O Me14b - tJb/L00K OV City 2 P ?siyo llt State VAe --Zip Z-24-If
Office Phone; L70 � Q2 7�27�d' Cell # 54070( Fay # _ E -mail
INFORMATION
-APPLICANT
Check any that apply: Change of ownership Change of use Change of name New business
Business Name/Type: ,�4-tASOAL OF CR W4E / RAU4 t+6A(eVW(` J_> 6105 '
Previous Business on. this site 0114 c yrs ole
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 :. Tt' ¢,; i/A. 400 ` '
_tgewaua Eew Mug IS 3js-y 71 Z1 0
`This Clearance will only be valid on the parcel for which it is approved. Ifyou change, intensify or move the use to a new location, a now Zoning
Clearance- will be required:
1 hereby certify that:I own .:or. aavc the ownea'sgermission ,o use the space indicated on this application. I also ceirtify fnat the information provided
is true and accurate tat e best of my knowledge. I have read the conditions of approval, and I understand them, and that l will abida by them.
-,-- -- 5t 7aiza
Signatur Printed
APPROVAL INFORMATION
[ ) Approved as proposed [ Approved v,{ith conditions [ ] Denied
[ ) Back -flow prevention device and/or current test data needed for this site. Contact AM, 977- 451:1., x117.
[ j No physical site inspection has been done for this clearance. Therefore, it.is not a determination of ccaanpliance with the existing
j site plan.
I [ J This site gompHes with the site plan as of this date.
I Notes:
Building Official Date �. t
Zoning Official ! Date / 9�s
Other Offtcial''''r`- Date
t:ounEy oa. Hlper Hum wupal L,Aj-,A- vt vv Faa ae+aa , ws i
401 McIntire Road Chariottesys'lle, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
4
L
Revised 711/20.11 Page 2 of '3
C,
C_
I
3
I
3
i
0
Intake to complete the following:
;Reviewer to complete the following:
Y J la
Is use in LI, lB or PDIP zoning? If so, give applicant a Cerfified
Engineer's Report (CER) packet.
Will ltthere be food preparation?
Square footage of Use: A
e J N
Permitted as. 4PAI<! l 54l`z -5
Cinder Section: /Vm
If so, give applicant a Health Department forth.
Zoning review can not begin until we receive approval from Health
Dept, FAX DATE
Supplementary regulations section:
Circle the one that a pp lies
Is parcel on private well i # ter?
epartmentform. If privatewcll,provide
Zoning review cannot begin until we receive approval from Health
Dept. FAX DATE
Parking formula:
Required spaces: ,
Y
Circle the one that apipjigs.
Is parcel on septic o pub-1 c sew ?
Items to be verified in tha:field:
YJ
Will you be putting up anew sign ofany kind? If so, obtain proper
-
i
.i �/ I
If so, List.
Sign :permit.
Permit #
Inspector bate.
Y 1 I`
Will there be any new construction or renovations?
Notes;
If so, obtain the proper Kermit.
Permit#
EJUjiiit tV 1JVLi1 tG4C+ il.,%�`. 1VIAVTidaa
''olations:
If so, List:
Proffrss
If so, ist:
Varinnce;
J N
Tf so. List:
-
i
.i �/ I
If so, List.
Clearances:
SDP's
Revised 71112011. Page 3 of 3
u
4
CERTIFICATION THAT .NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This farm must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
AdininistratorDeterrninations or Appeals, Sign Permits, Building Permits) if the application is not the
owner,
I certify that notice of the application,
[County application name and number]
was provided to the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number by delivering a copy of the application in the
manner identified below:
Hand delivering a'copy of the application to
dame 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 !,?J 0/ 3
Date
Mailing a copy of the appiicatian'to
[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 to the following address.
Date
[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].
Signature of Applicant
ovw, ��e_ try
Print Applicant Name
X13
Date
�t X31. U b•. W N «� TV • ,
i 0 r'•u- r °m iq" PLAT. ROAM.
�
1•� trlFr..,� d 7 rA pri a .. fits •;�{ '�J�� • d
r r,y � i• .� K ===iii ;",� o� � 9H Q '�S ¢., •
nnif �{�+((�yy�. H a 2{ v+N " =t . j. r; 'r ♦ ° � pr6 $ h•�
2Y S(}5i '"33 Isa r'. =r5t� • _ , ab ret. if' /S 4 ' 1 '.fps �7y^�'t � '
m� .� cs,.� .�SY.. ms`�r� • ' .. � t' r�� tt•,S� : x ` fS °Y,. � ��'�j.rD�A_..
' IIS b �N '� O > ' N4P 2'9m �/� •. .a'� Y. "i �'� �•?',LY.m4'� � � A e8
�,� , �" �t � ,.. J� '�3,Y+ L9� >m� �1�rif t v�t-S 1 �Qi43�41� ��.•fY r'' '• ��'+�..: C ��`�
> ��= �' ��" � triA( `� , Fr , s � �+3' •a it �r � A .(,yR�', y� y ' o �. )f
' r. N mg�� �� �t L�b;� !'�t(!k"5r,'tr'ro••�'4�,ir�l ,.... ,
>xNw y7 ' Ott1 ��� 'tt " ,,• Y"�, �66F1 ^ ,� i.r j��: •,�� rp 3 ..
'• S�iryn "tiq �p �z•8 "�ip%4`u 1 3�e. �� �r'�r
' �K'4�INm"�1 �y,+. Mir •�5.f 'l �� Ct ° x f'a,45�S'�•�. Se.• �. •F �h
v�}nn�gee iz Iw�;•+1�`•?'s''f1 �., J kri. + t , ,
�4VV1rt�Sp�pym4�.fEE& {`
.. ~ntf�y'lmQY �� j�l i1`S•`� 4ti... " ,�'4 '�L `�it�,�•� •q 31,E ry� _ m� ,.
.i6. •/p',�m ,' $pf5 •T A � � '(I'.• � K4i' ,. �y Y y'"yY' Tr
` VmiHij• Q� .r. ! Yx ;a'1. �,1 Y � •j S11i i, �� i s�q'i rry4 p�
� �y ,�° r� l +tyf n � ,C rylF n {�,4}j•Y �.. �MQt`f
it•' •1. t ' i����.�� I�; W�4 � ar�.� L��. �I. �„� Cm7: � .:0, r�•'• •. ,
p r4
to F , ��.1•i°°. ffx h jl�y -IL � . � �y , 1�
yg M9ynS7Q t ? yy Y {4 °,y.. �ti.. r• L ..
°• r
�+' � .. � •.T n`+i� .alt ,`.� ����� }'�ki. � � tlt r'����° �ly ,
a F dey, ; 'xS
. t fFhk. art , ' r �� r x,'%rcF ° ;,I�y' a a .s; ;'�y" ��-f •z •+ ,
iti qGk'. CSt7E- Ab�ti -z c �1aflD m, . , NAlcf{LINE
RAICH't1h`£ t i } r K °��. dams - i+.tTCH, l,.t.a.
tw p, Y
• ♦�� � •loin p�5 n R'�•
Jy `�? ,i9S' ,co ev.n �a •r.F
'pt e'p 7, 8�"r ,p, '
2 � •Yri
An
1 r c- An
to
3
ij
i
--z—Zo Fr-
. ... .. .. . ........
a
*r-
r�l
20
�33
F uj
�7
Itz
F4�
--z—Zo Fr-
. ... .. .. . ........
a
*r-
r�l
20
�33