HomeMy WebLinkAboutCLE201300280 Legacy Document 2013-12-31Application for Zonin Clearance
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Check # Date:
PLEASE REVIEW ALL 3 SHEETS
Receipt # M11 01111 Staff: �i
PARCEL INFORMATI
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Tax Map and Parcel: _Existing Zoning
Parcel Owner: 6104 e'
411W,4c' 'I
IVA
Parcel Address: �0 i S � city �I� I Mate _V Zip`"`'— `�
(includes t or loor)
PRIMARY CONTACT '
Who should we call /write concerning this project ?r
Address: A t/ 5%•-13 13 arroe,6 L►'c G\ City I� i, ✓ply �I��A State V ZiP 2�
Office Phone: ( ) cl�� °�Ct%� Cell # 1 Fax # E -mail fffe t0 a
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
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Business Name /Type: ' i� L 66Y1
Previous Business on this site
Describe the proposed business including use, number of employe s, numb of shifts, avail le park* .s aces, number of
vehicles, and n dd' ional i for at'on t you can provide:. n � l j �- h�,
*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 wn or ave the ner's permission to use the space indicated on this application. I also certify that the information provided
is true and accurate the st of wledge. I have read the conditions of approv and I understand them, and that I will abide by them.
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Signature Printed �' V
APPROVAL INFORMATION
[ ] Approved as proposed [ ] Approved with conditions VIeDenied
[ ] 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 sit complies with the site pla Las of this date.
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Notes % 9
Building Official Date
Zoning Official Date
Other Official Date
County of AMemarle 1Jepartmenl m %- ummuuuy i cv Auv&xa Aa
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 7/1/2011 Page 2 of 3
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Intake to complete the following:
Is/
Is us a, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
V a N
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 public water?
If private well, provide Hea epa men orm.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that appl
Is parcel on septic o public sewer?
Y�Wi be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y poobtain W be any new construction or renovations?
If the proper Permit.
Permit #
Reviewer to complete the following:
Square footage of Use:
Y/N
Permitted as:
Under Section:
Supplementary regulations section:
Parking formula:
Required spaces:
Y/N
Items to be verified in the field:
Inspector : Date:
No es: Y
uva■aaa w a.vaia
Vi l"ns:
YVV
If so, List:
,L
Pr nN s:
Y
If st:
,Ayriance:
/N
f so, List: ^�
's:
Y/N
so, List:
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Chu
a5 u am
Clearances: �
SDP's
Revised 7/1/2011 Page 3 of 3
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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
manner identified below:
by delivering a copy of the application in the
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
Mailing 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
to the following address:
[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 at tax assessment records satisfies
this requirement]. / //
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366e- I'l elYt
Print Applicant Name
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Dat
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Rebecca Ragsdale
From: Rebecca Ragsdale
Sent: Monday, December 02, 2013 2:16 PM
To: 'soberpierre @gmail.com'
Subject: CLE 2013 -280 Pearl Island Foods
Hello,
I tried giving you a call to get some more information about the proposed business, Pearl Islands Foods, LLC.
Will you be providing food service at Camp Holiday Trails or using their kitchen for a separate business? Please provide a
detailed description and indicate which building (dining hall ?) you plan to use.
Thanks,
Rebecca Ragsdale, Senior Planner
County of Albemarle
Department of Community Development- Zoning Services
401 McIntire Road
Charlottesville, VA 22902 -4596
(434) 296.5832 Ext. 3226
E -mail: rrazsdale @albemarle.org