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HomeMy WebLinkAboutCLE200700171 Legacy Document 2014-01-22Application for Zoning Clearance at nt.nE; �C` l .A0 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 OFFICE USE ONLY ❑ Zoning Clearance = $35 CLE # A Check # Date: PLEASE REVIEW ALL 3 SHEETS Receipt #. Staff: PARCEL INFORMATION 061M / Ma and Parcel: Existin Zonin Tax p Existing Zoning Parcel Owner: wc& / Parcel Address: 103-A- P u-C & ( ,yCity Ll Sy�Ile State (fa Zipaa9 — (include suite or floor— ). (J PRIMARY CONTACT 9 Who should we call/write concerning this project? �, �J �Q c �,) f� c J Address: / -city yr r \�1 State Zip g Office Phone: L__) Cell # E -mail APPLICANT INFORMATION Business Name /Type: rr, �d d Previous Business on this site 0 ^n E? Describe the proposed business, including use, number of employees, number of shifts, available parking spaces and any additional information that you can provide: S ­7 ?( 1 kcw, s p. ap s a e ✓i,n \. to � , } S� rJ� *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 Best of rny, knowledge. I have read the conditions of approval, and I``uu�ndersst them, and that I will abide by them. //and Signature' Printed iui f tlsc>n p L APPROVAL INFORMATION Den [• ] Approved as proposed [ p/proved with conditions a6 [ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 77 I l x..,�** e� aD(i/OC inspection has been done for this Therefore, it is not a determ nj iSYit d �g [ ] No physical site clearance. o-tact A A 977-4511, x 119 site plan. [ ] This site c lies with the site lan'as of this date. Notes: I/l�- GASi(/VL4lQ - INI1r.Q -{� �'C.(�VWLU• Building Official �— Date c�J Zoning Official Date Other Official Date 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 b' c . ., 7' Intake to ;NO l tithe following: F-1 YES Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report ER) packet. [] YES NO 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 Dublic water? If private well, provide Health D t -7b,n . Zoning review can not begin until we receive approval from Health Dept. FAX DATE ❑ YES ❑ NO Is parcel on septic or public sewer? ❑ YES [-90 Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # e e be a new construction or renovations? If so, btai the proper Permit./'/ Permit # Zoning Tech to complete the following: Reviewer t Squar �footq YES [ Permitted as: Supplementary regulati ection: ons a Parking formula: ( 14'E Required spaces: k ❑ YES ❑ NO Items to be verified in the field: Inspector : Date: Notes: Violations: Proffers: ❑ YES Q-`NO ❑ YES 0 If so, List: If so, List: Variance: SP' ❑ YES NO YES ❑ NO If so, List: If so, List: sp b V 5/1/06 Page 3 of 3 I sloop 10 laays SNnd U001A a 14laags LO /L0/E0 LO /Lt/l0 LO /90/40 908L9L 90AZ/60 90 /L0 /60 90%v0/90 �_ : suolsifia� 90 /9ZM0 : alep ou laajoi Ir WAUVO 'I NOIIV rn �� F C') o m Rf m C') n � rn � ovSmO � c � W �p cWn`DmZa° I o I n MP CD CD N r (AS '7L2'1) NV-ld �J00-1� iS61 A I X100(7 82j00 aI-lOS „8- .9X..0 -,2 ZO SHOOG - 18NVcA ..8- ,9X..0 -,2 01 i-in(EHOS X1004 I f—V �I`dl�a j M33N3A `d:,iWI3 4(115 9,x l 9NIUV3N +rIG'_13 a JNINOME Ql iOS a01a,1ad 3n0eV IVDS '3315 1£XAAa' -- I I I I I I I 3A09V >I71ae I f I I ONIN�IdO Hgnod• 119-.1 X .2 -.2 4 9 -,2 JNIN�IdO Honod (all 72 HG�JA) „Z -, 9X„0-, 0 „91/1 9-,9x..9/2-Z-.9 JNINgdO Hono6 (d Z+709 Wld-d) )\6VNOIiViS 8 „91/1 9- .9X,,17 -,9 JNIN�IdO Honod (Z -01202 H42i4) 6d V �-i(?aDH :)S -,MOCINIM (AS +7Z0 � I) NV-ld �100-1- QN00-:�S �'