Loading...
HomeMy WebLinkAboutCLE200700224 Legacy Document 2014-04-25Application for Zoning Clearance [31�oning Clearance = $35 OFFICE USE ONLYYa� CLE # y PLEASE REVIEW ALL 3 SHEETS Check # J 0 Otto Date: Receipt # -(04 I l Staff: :SLJ PARCEL INFORMATION Tax Map and Parcel: M 5,'� Z f Existing Zoning Parcel Owner: / 5 rS Cauali -tv J�1nVt?5�yr�elO� S, LLC Parcel Address: ISb17U - '>?,V1ntyWe Itral I City ( ,hctt og&5Vi State VA Zip ?d (include suite or floor) PRIMARY CONTACT l,, �I l Rtt. Who should we call/write concerning this project? 1 t (A V*Y\ S 1' L &0 l�ci.' 5 � Ck (off 0 A VA- Zip D A613 Address: l'1 City a f C5 State Office Phone: (43u) 9�% � % ��Q Cell # �/3y�q -���� ax # �3�/-`�l?�5421E -mail tdD�S �%� Ury4 l n fc� C f j. ca yot APPLICANT INFORMATI N/ //__ j Business Name/Type: r,5,, � L a l-B S L t ye r�(A i ��i�U �=y1 f Cs� i/iC� � V e %igYl d IL' � A" Previous Business on this site V, " 1 " VA Ct t Describe the proposed business, including use, number of employees, number of shifts, available parking spaces and any `c �i s 3 5 additional inform tion that yowulI, c�an provide: , VI , s e C✓ o c ee i *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 of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature /LC'p ,�,� -�;, —1A 7 Printed 23411d ndUif) 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, x119. [ ] No physical site inspection has been done for this clearance. Therefore, it is not a determina '1 nc wi t e ext tt1�g Bac ow fievice a110r site plan. [ ] This site complies with the site plan as of this date. urrent Test Data Needed. [Contact 977 -4511, x 119 Notes: ACSA L.,_,..,R,—.._ -- Building Official Date Q 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 a4611 Intake to complete the following: ❑ YES Qi Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. U-,(E's ❑ 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 .:..-C 7�1�✓/ ❑ YES ❑ NO Is parcel on private well or public water? If private well, provide Health Dew partment form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE ❑ YES ❑ NO Is parcel on septic or public sewer? ❑ YES ll�lvv Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑ YES Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # ZoninLy Tech to complete the followinLy: F I o 6r,;k p i cL--n o,,u C( Reviewer to complete the following: Square footage of Use: � oo YES ❑ NO ' ermitted as: Zai" f lstC/ Under Section: L-- Supplementary regulations section: Parking formula: Required spaces: ❑ YES]/ NO Items to be verified in the field: Inspector : Date: Notes: Violations: ❑ YES NO If so, List. Proffers: ❑ YES If so, List. NO Variance: ❑ YES NO If so, List: SP's: ❑ YES If so, List: 7'NO 5/1/06 Page 3 of 3 A,pplica` an -f©r Zoning Clearance r7 , A YfRlllr�' Q'L�oning Clearance = $35 OFF WE USE ONLYW...2 CLD+ .9 �f PLEASE REVIEW ALL 3 SHEETS :L • '• Check. # , 10 DCoD Date: )Reeeipt # it staff: kARCEL INFORMATION Tax Map a4tl ParceX: -rr / �G€V .0 t� i 1 j Exisfing Zoning Parcel Owner: 5 Cao ca l i t1' INN. , lyen� e WphiS, L Parcel Address:_ i ii Se.Wil �nr� e I I'Ai !Cite •�}Q �'a � �Si�t l State zip ` ...... ,.(inciude.suite.orflaor)• PI2TMAR'Y•• CONTACT Who should we call/write concerning this. project? VY" Address : 1160 /6rf :5 City �t oy- (o (I &-,5 X State VA- zip OfFiCO Phone: (4514) Cell # APPLICANT INFORMATZ N )) Business NamelT`ype: F6 L't f!L' �y d1.C� �t }n g E? z'1 r' Pro'vious Business on this site Describe the proposed business, iucludin ut e, number of employees, number of shifts, a'vallable parking spaces an any additional inform Lion that yoA can pr vide: rm ' 5" eE. S i }A AL a s a *This Clearance will only be •valid on the parcel for which it is a0ioved, if you change, intensify or move the use to anew location, a new Zonfnga Clearance will beyequired. I hereby certify that-1 own or have the owner's permission to use he space indicated on this applioaiion. I also certify that the information provided is trae and aeouratc to the best of my knowledge. I have read the.cond'itions of approval, and I understand them, and that I will abide by them. -Signature Printed a • � U >. APPROVAL INFORMATION [ ] Approved as proposed j j Approved with-conditions [ ] Denied [ ] Babktlow proventioiu device and/or•c'urrent test data ncpdcd for this site. Contact ACSA, 977 -451 I, xi 19. [ ] No physical site inspection has been -done for this clearance, Therefore, it-is not a determination ofcompliance with the existing site plan. [ ] This site complies With the site plan as of dais date. Notes:_ Building. Official Date Zoning Official Date' Outer Official Date Lounty 01 Albemarle Aepartment of Community Development 401 McIntire Road Charltittesville;i'VA 22907, Voice: (434) 296 -5832 Pax: (434).972 -4126 511106 Page 2 of 3 vo inaz v daS 97.Iti7.1RVF.b Xea LIWgWdMgAqn AIINf ani 3 Jie,