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HomeMy WebLinkAboutCLE200700192 Legacy Document 2014-01-22Application for 6fii ning Clearance � a OFFICE USE ONLY ❑ Zoning Clearance = $35 CLE # "-19100'7 PLEASE REVIEW ALL 3 SHEETS Check # Date: 7— / —U Receipt # Staff: 1,J !V41-trill *0 Q-1 col i -61 M CIM Tax Map and Parcel: �()o S Existing Zoning Parcel Owner: Parcel Address:-)--'7 2-1 j" ,`o qCt City eAW10 ! 6 01 tate V Zip zz�e (include sui a or floor) PRIMARY CONTACT /1 �% Who should we call/wri-te -concerning this project? + o k r F V r1 n i aun Address City C1A0* i its V State V Zip 2011)3 Office Phone: ` 5 1- C) %2 Cell # � Fax # �1 �Z E -mail 1'Yll "l Lev S(l DYl/u' f r�Csl ' APPLICANT INFORMATION Business Name/Type: 5 e-J-1 (1(11 S Previous Business on this Describe the proposed business, including use, number of employees, number of additional information that you can provide: Ri eAll '9;S Aal� Al-119, i&�( eSzqJe 13)lokeYG 3�'Vnl2 hal % o Cs4q/ I gifts, available parking spaces and any, *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 the best owledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature Printed BETE K t W1 t o uJ I APPROVAL INFORMATION [VA Approved as proposed [ ] Approved with conditions ...�.l�nied -•-- [ ] Backflow prevention device and/or current test data needed for this site. Contact AC E�n �lD EViCB ;�ntuOr ] No physical site inspection has been done for this clearance. Therefore, it is not a det Q 19j 1 1T@"1 is ing site plan. ACSA977.4511,x 119 [ ] This site complies with the site plan as of this date. Notes: Building Official Date 'I i Zoning Official Date a Other Official Date County of Albemarle Department of Community Development 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 YNO Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) 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 [!5'NO Is parcel on private well or public water? If private well, provide Health Department form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE f YES ❑ NO Is parcel on septic or public sewer? ❑ YES ❑ NO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑ YES ❑ NO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Tech to complete the Violations: ❑ x YESNO If so, Lis . Variance: ❑ YES' NO If so, List. Reviewer to complete the following: Square footage of Use:c� U RYES ❑ N Permitted as: r e-e, Under Section: c� a a 6 0 / Supplementary regula ions, section: V� (,w Cl-b a4) �t6 -- L ncquucu ❑ YES VNO Items to be verified in the field: k Inspector • Date: Notes: Proffers: ❑ YE� NO If so, Li SP'A: 25 YES ❑ NO If so, List: 511106 Page 3 of 3 0 Area 10 4�.e S hair 1 M '; jvv4 Ww f K**4 f %/ 1, tw& : 4750 Sq Fu r r-,. �-Ll ree rw, r i { Li!r e, ��cC' v►o�{,eel w rs ry'1'ONl�N ?4W }� Fu.v n � _ OFFICE Tirt ICE OFFI O o 71 C E '0 0 0 0 0 El ® — — TEAMING ARENLOUNGE 000 1 OFFICE CDA OFFICE `% O .�`� QG2 �j C SET \ �� � t \ \4 IN �\ ❑� ` \ �� �� OFFICE RECEPTION 1Y: u � i t'•`a'� '.Ff 4��� i < �� OFFICE w ,` 011 i rv- ' a —i� af'3` � ���€^��j_y. Y � ,�ti F`'✓ j �e i cK..rf� �� s� ❑.: .ia.;['�; %+�3 ,emu �... ♦ r a cr ,i, '4 �� �.-:b.. ,`:s .mss .: ci n. .7'a �.�•�- n � � ® _ — '> r s 4,.. a� Rr �+�� .s- ���y� � �;%� � .;::.,�... c..- {i��tixf`�i" �� ;!:.. -..... �'�' ":�, �, � x...� . _. .. __ � -... ORJfTAyOgs — 1 �4eFFI' _ f�Y -++13. CONFERENCE I b Flo CLIENT: — _ - WING Bondstone Ventures • .MANCINI •� DUFFY - - - ,�� �: _ PIANNWCtIi� 1412 Sachem Place, Suite 201 ARCHITECTURE •DESIGN Charlottesville,'VA 22901 DRAWWGTRIE ISSUE DATE: PROJECT NUMBER: pob.y,M 1647 �6F ki McMbm SP ri 99 Lane Trian le in Charlottesville, VA - ' 40ET�:sozin.2Uw F=2 ose1n3aso 2nd Floor ISSUE REVISION: DRAwwGNun R `iall� �odc°"°� "�"�' °° Final Space Plan • AB draMnlis unpublished one work f the a appearing and i ay wn dupl ofiginal U� � �� � �' � .. Celien�t eviecl w er and Used or wak of m wditn and may not be duplicated, �. � ��� �,�i/� "' —A J ASK-45 wed a dBelosed without wrBien mment of Iha aiehibct. D BY• CHECK BY: