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Home My WebLink AboutCLE200700127 Legacy Document 2013-12-13Application for Zoning Clearance J +II tea_ onzoo-7-)a7 ing Clearance = $35 OFFICE USE ONLY CLE # Check # _1,YP9 Date: r —O PLEASE REVIEW ALL 3 SHEETS Receipt # In C63 "] Staff. PARCEL INFORMATION f D Tax Map and Parcel: Existing Zoning i19' J Parcel Owner: Q V + T>,4- ! Parcel Address:_ 4CYO PeYY`'•° l ( Dv-„ City C V o-r t6 f1 ewl, We State VA Zip 2_2A l (include suite or floor) PRIMARY CONTACT Who should we call /write concerning this project? Y 1/ i A- V-! j 6 �1ry, c ',-/, Address: �c o w o ►^re ► 17) r• City State Zip Office Phone: 2 Cell # 60- Z Z Fax fi)— % -O 235 E -mail k14 n q ka 0 L jj i d1 Aq APPLICANT INFORMATION nn L L(, t 44- 611 Ie CI / A BusinessName/Type: Kq-e /+-�crkntcnC1 6 y V _ ... _ Previous Business on this site Describe the proposed business, including use, number of employees, number of shifts, available. parking. spaces and any additionalinformation. that on can provide: Q V,4r cj-,. c , -cky,- `—Fu *This Clearance will only be valid on the parcel for which it is approved. If you change, intensify or move the use to anew 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 t e est of my knowled e. I have read the conditions of approval, and understand them, and that I will abide by them. /II Signature l% ► dC Y� �i� t Printed l 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 ` ..1 Zoning Official Date Other Official s ayp�Y • t X (. AI Date- / l S I D 11 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 t— Application for Zoning Clearance r'urc;m� oning Clearance = $35 OFFICE USE ONLY CLE # Z dQ -7— ) 5� 7 PLEASE REVIEW ALL 3 SHEETS Check # If- Date: -O Receipt # Staff: PARCEL INFORMATION Tax Map and Parcel: U � G + Existing Zoning r-- " 1 D' ►/ ` Parcel Owner: Q V C-9 ( , �" 'I C° Parcel Address: �Co y��Yy''t=�� C),„ city C11-tr`10RRIiA� State �A Zip 2 -2& (include suite or floor) PRIMARY CONTACT Who should we call /write concerning this project? r V1 A- y-! j 0 � ry-L t Address: �oo w o ►^r-e 1 Dr. city State Zip Office Phone: ft 2 Cell # 9W -Z%2Z Fax #2_ "O 235 E -mail k U ti k-a @ V, 0 ,J? 1,q , dK APPLICANT INFORMATION r n Business Name/Type: 01^� Previous Business on this site � re- Describe the proposed business, including use, number of employees, number of hefts, available pa uk�ngfs,�aces,andany addi l?infomatinn that �pi,ou can provide: (2`'.. -.�-"` ^ -p n r. Li' r'N ` *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 t e est of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature d( t- Printed i " l A Y�� D 50' tl' 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 Q:,S'wa .�� t Date Zoning Official Date Other Official Date /i ,Lm Countv of Albemarle Denartment of Community Develonment 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 511106 Page 2 of 3 Intake to ; lete the following: ❑ YES NO Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. ❑ YES VNO 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 F-1 NO Is par 1 n riAcant ell or public water? If priv� e e l,e Health Department form. Zonin r ie begin until we receive approval from Health Dept. FAXbATE ❑ NO Is part 1 s p 'c or public sewer? ❑ YES [INO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑ YES G/NO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # EonmLY 1 ecn tO COMDlete the tonowmLY: Violations: ❑ YES If so, List: VNO Variance: ❑ YES If so, List: NO Reviewer to complete thp following: Square footage of Use: IVA 12 YES ❑ NO Permitted as: L&a _ Under Section: I DD e" Supplementary regulation section: Parking formula: ,, n Required spaces: ❑ YES ❑ NO Items to be verified in the field: Inspector : Date: Notes: J❑%YES ❑ NO If so, List: EP 's• YES ❑ NO If so, List: 5/1/06 Page 3 of 3 b