HomeMy WebLinkAboutCLE200700161 Legacy Document 2014-01-22Ok A1.LJ,ti!
Application for w In
®0c) � �k �rA'hY` /�
Zoning Clearance �3 5 0 \llm;�,r
to Clearance = $35
OFFICE USE ONLY
CLE # z cC . 7
Check # ', Date: t.11— —C)_1
PLEASE REVIEW ALL 3 SHEETS
Receipt # Staff:
•
PARCEL INFORMATION l % I�
Tax Ma Existing Zoning
Ta p and Parcel:
Parcel Owner: R.10 `
q
Parcel Address: �1� � �.Z:d° &)01e IL City C1'Att-OLI�1� State Zip
(include suite or floor)
PRIMARY CONTACT
' �� 51
Who should we call/write concerning this J I(y� �
'project. n
/
Address: 150 i k"O(,%Gt,'(�Qo0y hA) City `' egy 61�Z State y - Zip
Office Phone: Cell # .SAME Fax # Gq0 °ft- ST 33 E -mail
APPLICANT INFORMATION
Business Name /Type: (W Fes" CH
Previous Business on this site VA CA-VT 1 "Z s C� Gen)
L
Describe the proposed business, including use, number of employees, number of shifts, available parking spaces and any
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additional information that you can provide: 15 i 5 A VACAnr i CoLVOK 1-G'( Tti �1"i– ice•
CLA
d9 l —5- -0
*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 est of my kno wledge. have read the conditions of approval, and I understand them, and that I will abide by. them.
Signatur . /_ Printed
APPROVAL ,INFORMATION
[ ] Approved as proposed [ pprnoved with conditions [ ] Denied
[ ] Backflow prevention device and /or current tes data eeded 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 cor,»lies w h tl�sit�pla asat�
14/1
Notes: '-f A%1).,
Building Official Date (o f 1
Zoning Official Date �I
ss
Other Official _4'e . G� L' t C Date
County of Albemarle Department of Community lieveilopment
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 ❑.
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
❑ YES
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 or public water?
If private well, provide Hea t epa ment form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
❑ YES ❑ NO
Reviewer to complete the following:
Square footage of Use:
FYES ❑
Permitted as: Iwo)
Under Section:
Supplementary regulations section:
Parking
Required spaces:
❑ YES ❑ NO
Items to be verified in the field:
Is parcel on septic or public sewer?
ES ❑ NO —Fp � j I
Will you be putting up a new sign of an kind? If so, obtain proper
Sign permit. - Inspector : Date:
Permit # �
❑ YES. Notes:
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
ZoninLy "Tech to complete the tollowing:
Violations:
❑ YES ❑ NO
If so,. List:
Proffers:
❑ YES ❑ NO
If so, List:
Variance:
❑ YES ❑ NO
If so, List:
SP's:
❑ YES ❑ NO
If so, List:
5/1/06 Page 3 of 3
06/18/2007 09:58 FAX 434 972 4123 ALSE. FIRE & RESCUE (it 001
COMMUNITY DEVELOPMENTI Fax d34972412b JUI I 1 D """'
txon for;
A pplica
zoning Clearao;t
Clearance - $35 CLiI
onion$ Cb.ec
;PLEASE yEVmw ALL 3 S 1EJ�tTS Race
At
9
3 f
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.0 . _ E � O � x � —, c
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n NI �
Staff:
•' I
)P,p,.RCEL �rFO�(A,TXON
Existilag zonF
Tax Map and Parcel.'
L,L.C.
Pa)rce1Owper' `. - State Y zip ~r
parcel A,ddrass: 1
(Include suite Or floor)
t' roect? f�
) ]WM.A.R'Y CONTACT �
Vyllo shoLtld we ralUwrite colacerni.ng bus p 1 •� � � � State Y.�.
City
Address � !' SP `` �
A7t #
to -95S Si�� 1;'kn9af
office phone: () Z g Cell #
, yl)LXCANT INr
jauEiness l` amtTYPet
U(-
previous 131rsiness on this site �/�' pa `
avagaw parking sP21 -- and auy
to ees dumber of shifts, ` q - (
Describe the proposed busixtess, including use, nuMbeC of ejxP Y z ..
additional information that you can provide: �( � ;
A. --17
C areal for which it is approval, If you �c}�ange, intonsify or mOV a the uSe ro a raow location, a riew Zor�iXlg
*This Clearance will only bo valid on th p ..
Clear nr,c will be required, pp formation rovidod
that I o\yn or have the oyffi &s pctFnls9ion to use the space indim.tod 0, an
I u ra t d khan, � '� I will�abide by LbcsXl-
x l}creby certify cot o£ itrlo.*�ledge, ade read the conditions of �Pi
is true and 8cc1tate fA mY / SIiZ�pIL��
J>Yirrtcd
Si pate -
App)?OVAL.)Np'ORA'TYON [ ]Dbrded
p,ppsoved wilb conditi olds
a o oscd Contact A,CSA, 977 -4511, x119.
AppTcycd s pX p ce with the existing
and/ current tc6t data neodad for thie grle tt is not a dctetX 7ahon of compliance ( �ieLlctTow'prevrn <ion devicesrt f
Flophysical s1,teinspoctiola has bean done for this caearancc. The ; ;i
site plan � -��y.J
( ]This site complies with the site platof ibis ate- n f &(N r
Notes: kA4 %
Date I
Building OJ5cial 'i
'• � DRte
zoning ()ffacial
Date
Q f ficial '•
County of AXbepnalt ;1�e VA 902' oic O(A 96 p 7 3) 97z 06 6 2 of
•401 McIptire Road Charlottesv ,