HomeMy WebLinkAboutCLE200700218 Legacy Document 2014-04-25pry 5t Fim a utt a-Q
Application for
Zoning Clearance -"
OFFICE USE ONLY j
Zoning Clearance = $35 CLE # Q7 ri J 00 7 / F,- PLEASE REVIEW ALL 3 SHEETS Check # ,go S✓ Date: p
Receipt # Staff:
PARCEL INFORMATION f�Gr_ 00 &i'o�0
/
Tax Map and Parcel: 10W i O `�r�UU` b y — 000 C O Existing Zoning A M
Parcel Owner: S06Al2-A-'y . L L C
Parcel Address: 4 14 len wood 54-n oA) City O t ✓t t State -VA Zips Ol
(include suite or floor) Ga _ SU7 Zp
PRIMARY CONTACT
Who should we call /write concerning this project?
Address :6q D C //%LCity C{r']' ' V 1 Lt-0--- State VA4 Zipa�O/
Office Phone: to& Cell # aq9-35a-+ Fax #479-0119 E -mail
C7(� �IYi2. Lb�V1
APPLICANT INFORMATION _ F-1 Nom►" -A ADV,
Business Name /Type: 1 M-F- f4112IRi cS E r—1 u/� /�G! /� Se-tz l CES� .L�/G . — Off! GGS
Previous Business on this site NO "9
Describe the proposed business, including
additional information that you can vrovi
*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 Printed G 6-D/2- & G LJ . /2.a Y U/2,
AP OVAL INFORMATION 4 I —0-7
E7-04 [ Approved as proposed [ ] Approved with conditions J, yj Backflow prevention device and /or current test data needed for this site. Contact A SA, 1�'�qt Da 8°41ot' No physical site inspection has been done for this clearance. Therefore, it is not a detenn tq ;A 1
site plan. 511, X 119
[ ] This site complies with the site plan as of this date.
Notes:
Building Official Date.,�Gi 4 0
Zoning Official Date` 1 0
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
,o,g7- 3 z z co
Intake to complete the following:
❑ YES [] NO
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
❑ YES [J'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 public water?
If private well, provide Health Department form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
[?' YES ❑ NO
Is parcel on septic or public c sewer?
❑ YES F� NO
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit. 6,4J
Permit #
[]"YES ❑ NO
Will there be any new constriction or renovations?
If so, obtain the proper Permit.
Permit # -0200, -19�( C)7 N CCgrL. %?j I'D 6)
FOP-, !Jill /-r. a 00-? — 0 /QOz/_ /4?!�,
lecn to complete the
Violations:
❑
YES F'—NV NO
If so, List:
Variance:
❑ YES NO
If so, List:
Reviewer to complete the following:
Square otage of Use: 211.560
S7 ❑ NO
Permitted as:
Under Section: l W-- CAL
Supplementary reg I laions section:
Parking fornlula:
Required space . 1 8n
❑ YES ❑ NO ✓�,2
Items to be verified in the field:
Inspector : Date:
Notes:
YES . ❑ NO
If so, List:
SP's:
® YES ❑ NO
If so, List:
511106 Page 3 of 3
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