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CLE200700110 Legacy Document 2013-12-12
Application for Zoning Clearance OFFICE USE ONLY Zoning Clearance = $35 CLE # 2-007 PLEASE REVIEW ALL 3 SHEETS Check # Date: Receipt # Staff: { � A:•j A PARCEL INFORMATION y �(� Tax Map and Parcel: 6 d' 0 —C3j _00-o� -LA 6C% Existing Zoning i° Parcel Owner: h rb- %L_3" -+_- &[j bt y t K Parcel Address: �,LnQp i3m- %,gt_ky kus, City ele� ow(A State vA Zips r (include suite or floor) PRIMARY CONTACT 1 Who should we call /write concerning this project? Address: )-G M a0V_Y'6,C_kg VZ004 City State Zip Office Phone: 6190 162 -si.k "_ Cell # Fax # US— L41 ©`b E -mail _G.����.y► �� � ��4 P .�ssz;�i�to�l.sos�GL� aCa �� APPLICANT INFORMATION i Business Name/Type: YIC?.�(rlavrY� !?rc S �Cr Z14 �''�, la Cra,, - Previous Business on this site -S C, V% , ff G Describe the proposed business, including use, number pf employees, umber of shifts, available parking s aces and additional information that you can provide: 1�4 6tP� i�ca�/ tdSR .Qv-L, *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 t 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 ac ra to Te best of i no dg�, I have read the conditions of approvals and I understand them, and that I will abide by them. Signature ' Printed ` . t AP OVAL 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 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 511106 Page 2 of 3 Intake to complete the following: ❑ YES [X NO Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. ❑ YES [X NO 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 ❑ NO Is parcel on septic or public sewer? ❑ YES [x NO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # YES ❑ NO LAL Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # 0 %t� R d Zoning Tech to complete the following: Reviewer to complete the following: Square footage of Use: Igo Permitted as: Under Section: Supplementary regulat� sq section: Parking formula: Required spaces: ❑ YES ❑ NO Items to be verified in the field: Inspector : Notes: Date: Violations: ❑ YES [�NO If so, List: Proffers: ❑ YES Ej,<O If so, List: Variance: ❑ YES ❑ )1� If so, List: SP's: ❑ YES ❑ NO If so, List: y 511106 Page 3 of 3 Zoning Clearance Checklist Applicant MUST HAVE the following information to apply for a Zoning Clearance: 1) Tax Map and Parcel or Address, Building Name, Suite/Unit/Floor numbers, if applicable. 2) A Floor Plan - either a sketch or an architectural drawing a) If using less than the entire structure, note the location within the structure; b) Note the total square footage of the use; c) Note the square footage of each room or area of use; d) Note the use of each room or area of use. Conditions of Approval FIREWORKS: 1. No person shall sell, offer for sale, store, display or discharge any fireworks in any filling station or on any premises where gasoline or other inflammable liquids are stored or dispensed. (Code 1967 10 -13.) County Code Section 6 -200 and 6 -300 and must be a minimum of 100 ft from any gas pumps /propane distribution tank. 2. The site shall be cleaned and restored to its original condition on or before July 11th. This shall include removal of all structures, signs, debris, and the like. 3. A thirty (30) foot front setback shall be maintained, Display shall be located so as to avoid traffic congestion. Modifications subject to Zoning Administrator's approval. 4. Building permits shall be obtained for all proposed structures and /or lighting. 5. Sign permits shall be obtained for all proposed signage. 6. The sale of fireworks requires a special permit from Fire/Rescue department. CHRISTMAS TREES: 1. The outside storage of combustible material or flammable materials shall be located so as not to constitute a hazard and shall not be less than 15 feet from any building on the site. Any open burning must comply with the Virginia Statewide Fire Prevention Code and the Albemarle County Code. 2. The site shall be cleaned and restored to its original condition on or before January 2. This shall include the removal of all structures, signs, debris, and the like. 3. A thirty (30) foot front setback shall be maintained, Display shall be located so as to avoid traffic congestion. Modifications subject to Zoning Administrator's approval. 4. Building permits shall be obtained for all proposed structures and /or lighting. 5. Sign permits shall be obtained for all proposed signage. OTHER REVIEWS: 1. Is the property on public or private water /sewer? Private requires Health Department, Public requires ACSA review (2 to 5 days) 2. Will you be operating a bakery? USDA review is required (approx. 2 weeks but as long as 6 weeks) 3. If you are serving prepackaged baked goods but not making them on the Premises, only Health Department will review. (2 to 5 days) 4. If you will be operating any business that is in an industrially zoned district or of an industrial nature you will need to provide a Letter of Performance Standards or Certified Engineer's Report (a staff member will provide an information packet addressing this requirement) (5 to 10 days as soon as the Letter or Report is received by this Department) 5. If there has been no site inspection within the last three (3) months for the parcel /site, then one will be conducted to verify that the project is in compliance with an approved site plan (if applicable). 5/1/06 Page 1 of 3 g Q s X � CJQ � �U) f71 r"l7. v'VlpN 2 O ? '. coo co Lo m n II I II N 1 Zz ----" 1 Erb it U, Rp X/1 X I I r 11 ! o o,fZr1O_ II x ' I r A i r Z: V .'i7 I I f1��M T 7}J TOO, J ,.. 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