Loading...
HomeMy WebLinkAboutCLE200700108 Legacy Document 2013-12-12Application for Zoning Clearance )Y AL -,�tii ya County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 5/1/06 Page 2 of 3 1 lea OFFICE USE ONLY 2-0 ^ ,� CLE # C Zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS Check # Date: — 7 Receipt # & Staff: PARCEL INFORMATION %� /� ? F'(j d " " d 0 - b© "' 07 7�C3 P7�-/' Tax Map and Parcel: Existing Zoning ` ' Parcel Owner: ��G ��✓ `/T f`n' /��i� /S �/�N Parcel Address: �D� L�i�f�r/ �o�J City �State (include suite or floor) PRIMARY CONTACT 2VL 7iEe7�1� Who should we call /write concerning this project? Address : .30q ��fC /l�/Q� ��e� City � %�LO%7�'(/!�''State �/f Zip .,... �3C {�a4fa��G -a�Qy Office Phone: (Y3� 7 ��aa � Cell # Fax 5°3y E -mail APPLICANT INFORMATION Business Name /Type: Previous Business on this site � ��� /r!/$ l�/ �S' f�!/ /l'f"� .1-774L AM5 `lit/ <40MZCi Describe the proposed business, including use, number of employees, number of shifts, available parking spaces and any A/� W Z16XZ-? addition information that you can provide: X77 U -: 4 *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. Signature L Printed ,�IaL r 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, 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 site complies with the site plan as of this date. Notes: Building Official] -�-� -� Date Zoning Official u Date Other Official Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 5/1/06 Page 2 of 3 1 lea Intake to complet the following: ❑ YES O Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (C ') packet. ❑ YES Will 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 ❑ YES [ NO Is parcel on private well or public water? If private well, provide Health Department form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE ❑ YES [ja,1�O Is parcel on septic or public sewer? ❑ YES NO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑ YES NO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Coning 'reclt to complete the tonowmg: Violations: ❑ YES NO If so, List: Variance: ❑ YES ;? NO If so, List: Reviewer to complete the following: / Square footage of Use: d b d '3 r YES ❑ NO �+n lifted as: T �5S!aw.- �)A�Zct--, Under Section: `✓ �• 2 Supplementary regulations section: ��- ..sy Parking formula / /Z ,,, � Z0v Required spaces: I ❑ YES YNO Items to be verified in the field: Inspector : Date: Notes: Proffers: ❑ YES NO If so, List: SP's: ❑ YESAn NO If so, List: 5/1/06 Page 3 of 3 W. C. Porter Assoc., Inc. Page 30 304 Hickman "`� Approxirnat4 Only g7l REA p F USE ZZ7,156 'Del, Parking Lot SCALE: 1 inch = 18,00 feet 3 0 cn � U L C U L 1. W. C. Porter Assoc., Inc. Page 30 304 Hickman "`� Approxirnat4 Only g7l REA p F USE ZZ7,156 'Del, Parking Lot SCALE: 1 inch = 18,00 feet