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Home My WebLink AboutCLE201300153 Legacy Document 2013-07-29Application for Zoning Clearance E %_' 11� /I2fi1Nl'�� OFFICE US ON Y e 15 0,15 PLEASE REVIEW ALL 3 SHEETS Check # Date: Receipt # Staff: PARCEL INFORMATION Tax Map and Parcel: oq5* & -W -DO - 0) Mo Existing Zoning Parcel Owner: ��r� uA .- 2Dd e- e?- S,� Parcel Address: l- �it'aate� _Zip ?_5,a, (include suite or floor) PRIMARY CONTACT j /, j Who should we call /write concerning this project? ,o {t sr A& lam/',.? tT Address: S IZz City C gage- State V/q - 227 / /Zip Office Phone: Cell #�fJ7 /8'2Sx69Fax# E -mail S�vfl 26-&Q �iv6A-ic"x z APPLICANT INFORMATION Check any that apply: V Change of ownership Change of use Change of name New business Business Name /Type: �i" o > c:cx� . Previous Business on this site / . -- Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of �i� ve iclgs, any additional information that you can provide: � .6 914 11.�� 0 i1`.� i ,, n �r-�? f � *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. � %� L . � Printed �• a �"G,7i " - h� w ter/ Signature � APPROVAL INFORMATION >' Approved as proposed [ ] Approved with conditions [ ] Denied [ ] 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. [ ] This site complies with the site plan as of this date. Notes Building Official Date Zoning Official Date ��7 -�/ 0, Other Official 17 Date County of Albemarle I)epartment of t- ommunrty mevewp,uent 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 Revised 7/122011 Page 2 of 3 Intake to complete the following: P/N s use in LI, M or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. 'i' / N ill there 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 or blic wate If private well, provide Health Department form. Zoning review can not begin until we receive approval from Health Dept, FAX DATE Circle the one that ap ' s- Is parcel on septic r public sewer? Y �i Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Y Y there be any new construction or renovations? If so, obtain the proper Permit. Permit # 7.nnina to rmmn1PtP 1-hp fnllnwinu! Reviewer to complete the following: Square footage of Use: t ?lN Permitted as: , Under Section: Supplementary regulations section: Parking formula: �DVJ Required spaces: - Y / Items to be verified in the field: 6y-- S Inspector : Notes: Date: SP's: (D/N If so, List: Violations: &/N If so, List: � ((� Proffers: blN If so, List: 20 6y-- S Variance: 6) /N If so, List: SP's: (D/N If so, List: Clearances: SDP's Revised 7/1/2011 Page 3 of 3 CERTIFICATION THAT NOTICE OF THE APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER This form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning Administrator Determinations 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 [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 Date Zmailing a copy of the application 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 Print Applicant Name x -) /C/-7 /r t Date l� NJ DO 7 �--.' . Ally 2_ v � ---i COMMONWEALTH OF VIRGINIA DEPARTMENT OF HEALTH CERTIFIES THAT Smooth Operation, LLC is hereby granted a permit /license to operate a Fast Food Restaurant by the Albemarle County Health Department in accordance with the regulations of the Board of Health, Commonwealth of Virginia. FACILITY NAME: TROPICAL SMOOTHIE CAFE PHYSICAL ADDRESS: 1954 Rio Hill Center Charlottesville, Virginia 229 01 MAILING ADDRESS: 1954 Rio Hill Center Charlottesville, VA 22901 EXPIRATION DATE: December 31, 2 013 CONDITIONS: Kenneth E. Stutz, MPH, REHS Environmental Health Specialist, Senior Please direct questions or concerns to the Albemarle County Health Department, Environmental Health Services, (434) 972 -6219. This Permit Is NOT TRANSFERABLE From One Individual or Location to Another. Tropical Smoothie Cafe Albemarle County Health Department P.O. Box 7546 Charlottesville, VA 22906 Phone: (434) 972 -6219 Fax: (434) 972 -4310 URL: COMMONWEALTH OF VIRGINIA VIRGINIA DEPARTMENT OF HEALTH Foodsendee Establislunent Evaluation Report Establishment Information Establishment Name: Tropical Smoothie Cafe Establishment Type: Fast Food Restaurant Address: 1954 Rio Hill Center 3 -door prep unit Charlottesville, VA 22901 Evaluation Information Inspection Type: Routine Evaluation Date/Time: June 14, 2013 02:30 PM to 03:00 PM Evaluation Length: 0.5 hour(s) Equipment Temperatures Description Temperature (Fahrenheit) Walk -in freezer 0 °F Walk -in refrigerator 37 °F 3 -door prep unit 39 °F 2 -door fruit station 40 °F 1 -door reach -in (service counter) 39 °F Food Temperatures Description Temperature (Fahrenheit) Luncheon meats 39 -41 OF OF Person In Charge Person In Charge: Critical Hazards _ There were no critical hazards observed. Non - Critical Hazards There were no non - critical hazards observed. Comments Temperature and sanitary controls in place. Received by E H S - - - -- — -- Page #1 of #2 h Tropical Smoothie Cafe The above listed observations, violations and specified periods of time for correction of the violations are issued in accordance with the Food Regulations. It is the responsibility of the permit holder "to comply with directives of the regulatory authority including time frames for corrective actions...." An opportunity for a hearing on the inspection results, a time limit, or both, shall be granted provided that a written request is filed with the local health department within 30 days following the inspection report. Received By: Kenneth E. Stutz, MPH, REH Environmental Health Specialist Received by EHS Page #2 of #2