HomeMy WebLinkAboutCLE201400023 Legacy Document 2014-02-24Application for Zoning Clearance
CLE fl- Zo1 Z�
PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY
Chec # l� _ Date: `L
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Receipt # Staff:
PARCEL INFORMATION
Tax Map and Parcel: 061 WO-01 -00- 600 - 1- 13- /0 Existing Zoning �Et►�ui3ortt -leo o N�,o�EL
Parcel Owner: AWI (,c 1vAWg2
Parcel Address: 3 -yLQ L i"N�4uI�lyr„ CityC44AJ,!L )1 rylu,a State VA Zip2.Z90 ►
(includ suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? SUIT -- A - A L4 &g X W:V
Address : ' .�`� l Q, w,C,rt �fi_Aue- City C M44,6E,kL/1• State Zip ' Li0
Office Phone: 4413-1161 Cell # 1 y- S3)-.2W Fax # 3`%'97,7'0 -J3ZE -mail S N 0
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name v'-New business
Business Name /Type: f^o,x 135- -pol1-l1n
Previous Business on this site 0011,-, N <, -Nk60 tJS CQ9,PQI/lA:0Qh1
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
vehicles, and any additional information that you can provide:
S E >` A-rr n # 1
*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 f knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Sign at Printed
APPROVAL INFORMATION
> Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Backflow 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 r Date
Zoning Official Date Z1 & -z ?4y
Other Official Date
County of Albemarle vepartment of uommumty Leve1op111euL
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 7/1/2011 Page 2 of 3
l..
January 25, 2014
FOX BEDDING
Attachment # 1
BUSINESS DESCRIPTION
The Business operates by warehousing /displaying a variety of mattress /box spring
combinations and marketing its inventory accordingly and scheduling appointments by
phone with potential buyers to meet at the warehouse to show the customer the options, at
which point should customer opt to purchase transaction is completed and product is
pulled from inventory and loaded into customers vehicle.
Fox Bedding has no employees, no company vehicles, no set hours operation thus
schedule is determined as appointments are set.
pn
Intake to complete the following:
Y/I
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y / N�
Will -e 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 public wate
If private well, provide partment form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applies
Is parcel on septic or lic sewer
Y /NN
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
YLV,-
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zonin to corn lete the followin
Reviewer to complete the following:
Square footage of Use:
0 er /N
mitted as:u ✓o� ✓�
Under Section: VlRj C U •�
Supplementary regulations section:
Parking formula:
y00
Required spaces: 3
Y /Tq
Items to be verified in the field:
Inspector : Date:
Notes:
Violations:
Y/O
If so, List:
Proffers:
A/N
so, List:
Variance:
Y /8
If so, List:
O 's:
/ N
If so, List:
Clearances:
SDP's 4
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Revised 7/1/2011 Page 3 of 3
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CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the
owner.
I certify that notice of the application,
[County application name and number]
was provided to 4 6j o wlt AdU0 —i /WSj— the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number
manner identified below:
by delivering a copy of the application in the
✓ Hand delivering a copy of the application to 4 wymiL.n. 1, Ne) ,�.us� /�S&K- A KtC�? i
[Name of the record owner i the record owner is a
person; if the owner of record is an entity, identify the recipient of the record and the recipient's
title or office for that entity]
on '
Date
_ Mailing a copy of the application to
[Name of the record owner if the record owner is a person;
if the owner of record is an entity, identify the recipient of the record and the recipient's title or
office for that entity]
on to the following address:
Date
[address; written notice mailed to the owner at the last known address of the owner as shown on
the current real estate tax assessment books or current real estate tax assessment records satisfies
this requirement].
Signature o Applicant
_Sv'6r-
Print Applicant Name
i ks-h/V
Date