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CLE200700213 Legacy Document 2014-04-25
B�s� �� ©per . . Application for Zoning Clearances`.. Zoning Clearance = $35 OFFICE USE ONLY , Y . CLE # Z - Check # Date: PLEASE REVIEW ALL 3 SHEETS Receipt # 4,,76ZU Staff. PARCEL INFORMATIOpN Tax Map and Parcel: p ` e? A Existing Zoning (f ^ J� ' 1 / Parcel Owner: 1 p�d �vy L, , N�E'a1�0.WA� Parcel Address: lot �c V,t d et &Ke City lr.-L a lo7�nysYle- State (include suite or floor) PRIMARY CONTACT ,/ Who should we call/write concerning this project? �/,��/i.>c m eaiL Address: c2g' � �'U kl- //00-,v C7_ City ; ce1Z& -SV,,11e State 114 Zip Office Phone: (Z k) q9O '90240 Cell # W ' '515yl Fax # 03' Pf ®SY3 E -mail u%/(CQ� APPLICANT INFORMATION J Business Name /Type: Co¢iy7;2�/;+1 ✓' /tol� J��NSf�0�2r,g�ioN G ;il�dtJst+/ LLid'L��`i✓ Previous Business on this site 0.0 -0."l. Describe the proposed business, including use, number of employees, number of shifts, available parking spaces and any additional information that you can provide: *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 two the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. , °"`'_ 14--— Signature Printed A � AL INFORMATION B as [ /Approved with conditions e and /or pproved proposed TqD ata Needed [ ] Backflow prevention device and /or current test data needed for this site. Contact'ACS &;;4n' §t [ ] No physical site inspection has been done for this clearance. Therefore, it is not a det a ��(�li�o� ig site plan. [ his site omplies with the site plan as of this date. - Notes• 01 � V t l Building Official Date 0'1 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 (40,,v7 Intake to complete the following: ❑ YES ![�O Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. ❑ YES 0 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 sewer? ❑ YES... Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑ YES aKO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Zoning Tech to complete the following: Reviewer to complete the following: Square footage of Use: ❑ YES ❑ NO Permitted as: 14� Under Section: Supplementary regglati ¢ns fsection: Parking formula: ,��• ] _ _ f, /� ^ Required spaces: ❑ YES ❑ NO Itemsito be verifieg-in the field: I i 1 Inspector: Date: Notes: Violations: ❑ YES ❑ NO If so, List: Proffers: ❑ YES ❑ NO If so, List: Variance: ❑ YES ❑ NO If so, List: SP's: ❑ YES ❑ NO If so, List: 5/1/06 Page 3 of 3 hays NVld Ha01d MH Bala '1SIX3 a ms 9N6Z/60 suo s 9D/OE/EO : e1 ou tae of ball iv 83AUVO.1NO1lV m Fn W CD o m 5 � z � a m n n a � j a Wy?'Ci sow 5 m �r� w p z cm w�o� � 22 N r OI11V NI 033Vld 98 Ol OVAH (583W800 3H1 80d altos 80 9NnH 3-19NIS) SN3380S ONV SSVl9 N93M138 TII89 /M 9NnH menoo 031VlnSNI 38 Ol SMOONIM S8000 031VlnSNI "IV13W M3N 38V S8000 801831X3 I-IV G10N �3NVd '10313 - 33VA ZI 3(lIs1n0 NO -I3NVd 8000 03XId- -,;-t ' ss SITS NV-ld �100-1A MAN E)Nla-line '1SIX�i .07 .01 .0Z ---------------------------------------------------- 9 R .9 —kra 9 V.9 .9 .9 JJ .A J 8000 MEN I I � I I I I ..£ -.Z I I I I l0A .6 -. Z l0A ..I -. S ---- - - - - -- I I 9A08V 0 i i F,----, 1H 81M /M S NNI I /M NIS d ll I Nye STIVM 801831X3 NO l'1VMA80 2/1 M3N "13NVd 9 8000 M3N 21000 M3N mob' �L�r •` � ?� �� '�T72L .01 dAi S7VM 801831X3 NO 11VMA8a .Z /I M3N l0A 30Vd 301S1n0 NO -13NVd 8000 03XId .ZI