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HomeMy WebLinkAboutCLE201300166 Legacy Document 2014-01-13Application for Zoning Clearance ov �� "�� CLE # OFFICE - lo� PLEASE REVIEW ALL 3 SHEETS Check # Date: Receipt #w Staff: PARCEL INFORI% —;�- 0 P I) �10f'�(ce] Tax Map and Parcel: .32.3 Ga1 Existing Zoning Parcel Owner: 9,,,, a Ao-wz's Parcel Address: 3,4 NO,' T City J E- State -.-Zip , (include suite or floor) PRIMARY CONTACT Who should we call /write concerning this project? Address: 45-7 S ,bJ14 4Q • 1� City State V a Zip a J f Office Phone: (_ ,V4 Cell # Fax # E -mail UKIXi(o NOU000 ."W-, APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Chan a of name New business Business Name /Type: Previous Business on this site 0 met Describe the proposed business including use, number of employees, number of shifts, av ilable parking,s aces, numb pr of vehicles, and an dditio 1 inf rmati th t you can /provide: ,�rrJ to X— 0 dvl�,e Z jrl � C.fZS v IcR- 0 �J �� to f •(lei 614, W ! .1.e- S (suds4 ax" ac! 2- *This Clearance wil my 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 o have the owner's permission to use the space indicated on this application. I also certify that the information provided is true and accurate t be t of my owledge. I have read the conditions of approval, a I understa them, and that I will abide by them. Printed y0 ►a Signature �.J APPROVAL INFORMATION LX Approved as proposed [ ] Approved with conditions [ ] Denied [ ] Bacicflow 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 site complies with the site plan as of this date. Notes: Building Official Dated Zoning Official �A, /?✓ it Date 11J 5' 3 Other Official Date County of Albemarle Department of Community Ueveiopment 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 Revised 7/1/2011 Page 2 of 3 Intake to complete the following: Y /N@ Is use in LI, HI or PDIP zoning? Engineer's Report (CER) packet. If so, give applicant a Certified Y /1`tlres Wil re 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 or _ lie water. If private well, provide Heal epa - ment form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applies Is parcel on septic o ublic sew Y/N Will you be putting up a new sign of any kind? If so, obtain proper Sign perm t. w � Permit # 'r °-, Y/N Will there be any new construction or renovations? If so, obt ' t e pro er`P.e. fit. Permit # d Zoning to complete the following: Reviewer to complete the following: Square footage of Use: e l N P�1 h` Permitted as; lu�J Under Section: Supplementary regulations section: Parking formula: Required spaces: 2 Y / � .J Items to be verified in the field: Inspector: Notes: Date: Violations: Y/ If so, L st: Proffers: Y/N If so, List: Variance: If ogist: SP's: If s/o; List: Clearances: SDP's Revised 7/1/2011 Page 3 of 3 (Page 5 of 6) *-.N - i� N w � • • O O I C z z 0 d o < iv ai � m -4- -,j OD 0 W °- m0 �W ��p`zDLA w m II��N pm m rtl I O p w �- - -- z •--1 m N -o ;a ro OO -� rro n D� D N z z w pp O cl �Ott,n 29 A O OD ©o l P .51 14 1� 17 d'Tl ix7 0 w M -A L� I m -OP n w TO N26 °33'55 "E 699.67' Cum d bo O- M, M. ODD W r W� at7D -iD-1 ooas(n Ox� ON a coo z I >00.t °- m0 �W (n gm' C) a1 . NOD t- � WO -U00C (O OO r' zm� DW-2:q -t.p, zz O .<m + � (n D �- - -- ©o l P .51 14 1� 17 d'Tl ix7 0 w M -A L� I m -OP n w TO N26 °33'55 "E 699.67' Cum d bo O- M, M. ODD W r /i at7D -iD-1 ooas(n Ox� ON a coo z --ova' N o 4r,5 m ©o l P .51 14 1� 17 d'Tl ix7 0 w M -A L� I m -OP n w TO N26 °33'55 "E 699.67' Cum d bo O- M, M. ODD W r m ro 00Comm >N:� {t A o O��D�I�W z m �°Nm N'P�i t�Oi,a°oa' C7 �'' to - rr o0o D Ln m Oz C-3 m 470 le- S33 4,09'50 "W 652.67' ro C7 O °�rn� 171 ga_u) k --1 30 1 0O a1 . NOD t- � z I x W m p cc A O ro A CJ1 �D�N O m ro 00Comm >N:� {t A o O��D�I�W z m �°Nm N'P�i t�Oi,a°oa' C7 �'' to - rr o0o D Ln m Oz C-3 m 470 le- S33 4,09'50 "W 652.67' T TO w >�, g 7-, O RT• 649 3Z ° O cl �Ott,n 29 O NS. rF N D k . —ODc) D -n � z mo ' pz N _ O y aD N W - X -u r< m o � ao in in 4s 142.35' m ' I