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HomeMy WebLinkAboutCLE200700121 Legacy Document 2013-12-12Application for Zoning Clearance ©ccu r" ,,.,,". OFFICE USE ONLY Zoning Clearance = $35 CLE # C._. PLEASE REVIEW ALL 3 SHEETS Check # i Date:_ S R Staff: PARCEL INFORMATION 2 �. r Tax Map and Parcel: % � -A ' 0 2- 4 30 5 Existing Zoning 17a�M Parcel Owner: (�,�,,r rI Parcel Addresso,44 6tt"WDOA �7'IW►V�YI CCity��irlGl�ii W 4& Vi blstate VA Zip (include suite or floor) X302 (ji/1NA "b 03 PRIMARY CONTACT �� r Who should we call/write concerning this project? ,,��� 1�n � n� ��� • � Address : (A0 ?)MV•y V'� Cif kkr-, city l kl 1 V1 LVC State VA • Zip a OJ Office Phone: eL" Il� ]- p (c Cell # 2 2 5 a Fax # all 9 Q l l � E -mail quo role (� S m.axl iC. L DTI E 1/Yl.� . G f�W►i APPLICANT INF Business Name /Type: Previous Business on t Describe the proposed business, including use, number of employees, number of shifts, available parkin spaces 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 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. Signatu� Printed G e l/,J ' i20(V �1'Z• APPROVAL INFORMATION 61-110-9- ] Approved as proposed [ ] Approved with conditions • [ ] Denied [ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, xl 19. [ ] 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 co lies with the site plan as of this date. Notes: U°� 1 iz-t�J41�, Building Official �! Date (1 ' Zoning Official . 46 4L Date % 0 Other Official Date County of Albemarle .Department of Lommumry ueveiopmeuL 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 N NO Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. ❑ YES [X NO I- 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 oi ublic water9 If private well, provide Healt epartment form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE XYES 4—NO arcel on septi or public sewer ?, ❑ YES M NO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # 9 YES ❑ NO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # ab0"l — I O L�j Zoning Tech to complete the following: `jT V'olations: ] YES ❑ NO If so List: Variance: ❑ YES V] NO If so, List: S Reviewer to co gte the (following: Square footage of Use: / 1 [YES ❑ N Permitted as: C� /G Under Section: oA -6 c,6,b Supplemen ary regulations section: a6+« Par in 6 6rnlu a: �O r h p_ 6AAY—d LC4��J Required sp es:' ❑ YES ❑ NO Items to be verified in the field: Inspector : Date: Notes: Pro ers: YES ❑ NO If so, List: SPA F✓[]AYES ❑ NO If so, List: SPzeo3 -�q ,�P16�- 5/1/06 Page 3 of 3 ^J J b' U) A z Z � o O m `0 D 0 < m D D a z 0 m � o 1 ii 0 rn w Z Z v o rn 2-, x W V C/) � D cn CO =- � 0 C D 0 --irr% r D n � a � 0 °o_ D = m N C =` ' �. c� o CD 0_ C. EL CD c0 m = =r 0 SD O E O 0 w Q. O V) 7 CD O D� D m gyp; ;� - � �6 � z yU! n syiy•^ P 6 �e z �m z� H �n wm A m OT m m to m 0 T T m 0 T T m m 0 �I A O 0 Cl) c m r�r W N T I II II II II �0 II 10 o I° II II Im T III Im II Im II m UL Iw II Iti II I, II II 21041 a0� I � I I m © I I° II o II Im 11 6L m 0 m III I i I I ❑o n i O m °z H I I z Ni D m n ii Z v o rn 2-, x o O � ZDrG7 W A --irr% r D a � 0 m m OT m m to m 0 T T m 0 T T m m 0 �I A O 0 Cl) c m r�r W N T I II II II II �0 II 10 o I° II II Im T III Im II Im II m UL Iw II Iti II I, II II 21041 a0� I � I I m © I I° II o II Im 11 6L m 0 m III I i I I ❑o n i O m °z H I I z Ni v h a < Y D r mIr, p I I j m — M1' I ❑ I' r ell if Id lJ u lu 0 0 rl Ia a ' `& ti 4 1' - ^(.'rte - o _ n" p ' \ \ \ \I: \ \♦ \ \ \ \ \��� \ \\ , - - _ GQA rl e Nil "^ly -'- ti .� Vl.l ♦ Nil A -a UR ft Nur /r Za C� / �5? ^a y v `fir oln m.'vDl n fro f'l NT '^boa - rO�Nr"iiAm y. viT rj FG � I_ '. ,S,'�j ♦ l u Q r m zT.mYrs "> nulsrN, -irl- a�, v III ifj,�' zn Z --no z�r"a.- DOOOmn a°i tF} \� �l:11��~;sd ♦.���:_'J I�/ ED C — ' i N C LJ Ng 25 P-4 _ T � O y kia4nh�h����i�� fjs4��4f S7. � L •LL� z:i�x�r'Y, xfa'a an in J 7� ob5 0 40