HomeMy WebLinkAboutCLE200600209 Legacy Document 2014-04-25Application for �P 110k 'D
Zoning Clearance z
OMCE USE ONLY
Zoning Clearance - $33 CLE # -7-0C) —
PLEASE REVIEW ALL 3 SIMETS Check# �tVt -7r Date: 60:
,Receipt # _e,3J1n-;3Z4 — Staff:
PARCEL INFORMATION
Tex NJ:ap and Parcel: Existing Zoning N wl D
Parcel Ch ner: 1'ia �t l t_ HavN -,ih ,Frppu- liesc
Parcel Address: (I VZ T City C,+n U11 state zip Ugs-L
(include suite or floor)
PPJI%URY CONTACT
Tito should we ctllfwrite concerning this project? f3c�4-1'1 1 �G
Address _R D. Bose S"}- _ City C -vt11L slate Vii' zip ZxaOZ-
Office Phone: C) °1 �-I' L'l�t w . til # $7,S • �''[3 Faz # a'-!• 5 lSRs E-mail bcsN+ ; iCc ea.. t�:, . •got
APPLICANT INFORMATION
BusineasNamef][h*; Sjz ys r G01S CXab C1�i_•1c C.ha.IL!=W mI&.;k ' -F, M.0(.)
Previous Business on this site VIA, Tr,,al -r;wv% Ce.i 4e4-
Desiodbe the proposed business, including use, number of employees, number of shifts, available parking spaces and any
additional information that you can provide: ;6 , c1- t j,, .. Swtid�„ � 9, E-4-, •'[ $t 'iaNn }GMU CU&
W M ir1DS4 +.,.r- I" �va�.J rar'--tuft— n1e. �.u.eci & e u Tvu ! _ W.0 Aa os r.ilaie
I (*** y M00 twVrA* 4Cweb I a o< 2' x 2..0' C-Opc . -(e.w }.
*T.his Cleamme will only be valid on the parcel for wwhiah it is approved. if you change, intensify or move the use to a new location, a new Zoning
Clearance will be required.
I hereby CWW that 1 own or flaw the ownd s pormission io use to space indicated on this applicafion. I also certify '!$at the in'£3rms4ion provided
is irue and s 1te best of my leaw1c4go. 1 bave read tlx oondifions of approval, and I undust'and them, and that I will abide by them.
suture
Printed
APPROVAL I.NFORM&TION
[ Approved as proposed [ ] Approved with conditions [ ] Deniod
[ 1 BackRow prMution devict and/or ou rent rest data needed for this site. Contea ACSA, 977 -4$11, x119.
j
)No physiol site iuspection has been done for this clearance. Therefore, it is not a deiennination of compliance with the ea-isdug
site plan.
j 7 This site complies with the site plan as of tltis date.
Notes•
Boiiciing Official
Zoning Official
Other
Date
Date j
Date
County efAlbeinwi Nperfine rtt of COMMMaitp Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-n32 I'= (434) 912-4126
5/1!06 Page 2 of 3
Intake to complete the following:
❑ YES U4O
Is use in I I, HI or PDIP zoning? If so, give applicant a Certifiiied,
Rn&eees wort (CER) packet.
P'�S ❑ NO
Will thm be food prreparafion? 14LC. � qa � - '
If so, give applicant a Health. Deparhnent fbim.
Zom ng review can not begin until, eve receive approval from Health
Dept., FAX DATE , �5.^ . 7O
❑ YES NO
Is parcel on private well or public Water?
If private -neli, provide Health Depar -Wient form.
Zoning review can not begin unti we receive approval f om Heeth
Dept li DATE
S ❑ NO
Is parcel on septic or public server?
❑ YES ❑ NO
Will YOU be puffing up a new sign of any kind? If so, obtain proper
Sign permit. �y
Pertmft #7��213t31�
❑ YES ! -KO
Will there be any new construction or renovations?
If so, obtainn, the proper Permit.
Permit #'� .t
Tech to
❑ YES ❑ NO
If so, List:
Variance:
❑ YES ❑ NO
If so, List:
Reviewer to complete the following:
Sure footage of Use,
❑ YES ❑ NO
Permitted as:
Under Section,
Supplementary regulaticros seoiion:
parking foamula:
Required spaces:
❑ YES ❑ NO ___ --
Items to be verified in the field:
Inspector
Date:
Notes:
511106 Page 3 of 3