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CLE200700150 Legacy Document 2014-01-09
', Stipp Ar.bi.•r Application for Zoning Clearance OFFICE U E N Y I. ❑ Zoning Clearance = $35 CLE # Check # Date: - PLEASE REVIEW ALL 3 SHEETS Receipt # Staff: PARCEL INFORMATION 1� Existing Zoning .. ` Tag Map and Parcel: V Parcel Owner: 11 d b tAt 'D • `u �( (CAS c�2M�n01e ' 1 ty 1.V1, v�r�Z State V ,4 Zip e�iai� I Parcel Address: ��cxi Ci (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? Address 30©01 �I.r ('. City ��i State A Zip 77tt off. Rirt 3 1�- E -mail r�cv5� ®C °:nticsos�'. �le`� Office Phone: l3 a- � 33 6 Cell # -74a to 7 Fax # j APPLICANT INFORVATION . Q t u{'o r• ,� Business Namerrype: e �� S t c Previous Business on this site Fv T n (+v re. � Describe the proposed business, including use, number of employees, num er of shifts, available parking spaces and any additional informati n that you can provide: Sake 5 r, O-N.e i3 *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 I hereby certify that I own or have the owner's permission to use the space indicated on is true and accurate to the best of my knowledge. I have read the conditions of approval Signature n Printed A �PROVAL INFORMATION Approved as proposed [ ]Approved with conditions [ ] Backflow prevention device and /or current test data needed for this site. C [ ] No physical site inspection has been done for this clearance. Therefore, it site plan. [ ].This site complies with the site plan as of this date. Notes Building Official Zoning Official Other Official us application. iI also certify that the information provided and I understand them, and that I will abide by them. i rtact ACSA, not a determ Date Date Date [ ] Denied =4511, x119. ion of compliance with the existing County of Albemarle Department of qommunity Development 401 McIntire Road Charlottesville, VA 22902 Voic : (434) 296 -5832 Fax: (434) 972 -4126 511106 Page 2 of 3 Zoning Clearance Checklist Applicant MUST HAVE the following- informatio 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 dra _ ing 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 f use; d) Note the use of each room or area of use. -of F1 REWORKS: or discharge any fireworks in y filling station or on any premises where gasoline 1. No person shall sell, offer for sale, store, display ode 1967 10 -13.) County Code Section 6 -200 and 6 -300 and must be a or other inflammable liquids are stored or dispensed. (C 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: able 1. The outside storage of combustible material or flamm materials shall be to ated 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 ith 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 pen-nits 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 Prem ses, 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 industri it 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 )epartment) 5. If there has been no site inspection within the last three (3) months for the par el /site, then one will be conducted to verify that the project is in compliance with an approved site plan (if applicable). 511106 Page 1 of 3 Intake to complete the following: Reviewer to complete the following: ❑ Square footage of Use: YES NO S� Is use LI, HI or PDIP zoning? If so, give applicant a Certified packet. [YES ❑ NO Engineer's Report (CER) p Permitted as: ❑ YES NO Under Section: z 2 ' 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 Supplementary regulation's section: Dept. FAX DATE �yyej5s ❑ YES F-1 No Parkingformu]at 3 07y Is parcel on private well If private well, provide form. not begin until we receive approval from Health Required spaces: 3 Zoning review can Dept. FAX DATE ❑ YES NO ❑ YES ❑ NO Items to be verified in th i field: Is parcel on septic or is sewer. ❑ YES ❑ NO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Inspector Permit # Notes: ❑ YES' ❑ NO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # ;onin Tech to complete the following: Proffers: Violations: X. YES ❑ NO ❑ YES �'`NO If so, List: If so, List: Variance: ❑ YES ❑ NO ❑ YES NO If so, List: If so, List: 31. _ Z( Date: �r 511106 Page 3 of 3