HomeMy WebLinkAboutCLE200700209 Legacy Document 2014-04-25Application for
Zoning Clearance
Zoning Clearance = $35
OFFICE USE ONLY
CLE # Z00-1—z'09,
PLEASE REVIEW ALL 3 SHEETS
Check # Date: �' ,a Z
Receipt # Jfi / DQ S Staff:
P �T
PARCEL INFORMATION
Tax Map and Parcel: 061 KI0'+01 "(.JA °-' Lid 60o ExistiJZo n L DA
Parcel Owner: wi mi L uo, I — S E A-L,6
Parcel Address: '34c (71wj Pktee_ flz City CiW. 'ALLE State �b 1 Zip 226?a1
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project ?AULI �d ('— Iil alOOi7L
Address To City C'tW JV 1 LL_C State �i Zip2 _Jr
Office Phone: &9A qq 5-') ell # Y0 b2. Fax #973 --I5oq E -mail ,PV 6j7_PQ0QW-6 k-_ ML.ehl
APPLICANT INFO_ RMATION n
Business Name/Type: �,Q-�i) I il5 i STiC [us/i�
Previous Business on this site Ij�S� �jl� Lw y I s
Describe the proposed business, including use, number of employees, number of shifts, available "'irking spaces and any
additional information that you can provide: �( (�E S�� A�-TUWA. ` LzL i)m 06J
*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 accur o the best of my la)owled . I have read the conditions of approval, and I understand them,, and that I will abide by them.
Signatur Printed p �� %— 1Ai L%C
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, xl 19.
[ ] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing
site plan. _
[ ] This fi• e complies wit the site plan as of thine
''(l
Notes: �-
I-elv-64- 3 -
Building Official Date
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
511106 Page 2 of 3
EVERGREEN MINISTRIES
PO Box 5401
Charlottesville VA 22905
434 - 973 -7825
Wordtight(D- aol.com
Stanley E. Woodfolk, Pastor
to r�G�-
liIlopment
C��,,, ✓v,�,i,� ` . jiness
friendly church witl
wad
c.0 cC.
(2) full -time staff (1,
)a — 4:00p Monday
G ices are held on Si ' h z
i,on Tuesdays at 7:00p. We offer spiritual
ining classes and workshops on a regular basis,
coholics Anonymous (AA) meetings are held
'it location for us because we were told that it
marle County with plenty of parking that was
Plus the other businesses in the building did rbf
hours. The property is on the bus route and in
Ned residential area.
'The Church Where Everyone Is ZWekvme'
340 Green6rier Drive— Cfiarlottesviffe VA 22901
Intake to complete the following:
[t ''YES ❑ NO
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
❑ YES
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 ..w&r9 ,
If private well, provide He a tl h Department form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
❑ YES ❑ NO
Is parcel on septic or public sew wer?
❑ YES R NO
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
❑ YES [�N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning Tech to complete the followine:
Reviewer to complete the following:
Square footage of Use:
❑ YES [/NO
Permitted as:
Under Section:
Supplementary regulations section:
Parking formula:
Required spaces:
❑ YES ❑ NO
Items to be verified in the field:
Inspector . Date:
Notes:
Violations:
F-1 YES 7/ NO
If so, List: t 2 Q
Proffers: �
❑ YES rn �O
If so, List:
Variance:
❑ YES NO
If so, List:
P's
KrYES ❑ NO
If so, List::�� 3,
5/1/06 Page 3 of 3