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HomeMy WebLinkAboutCLE200700255 Legacy Document 2014-04-28Application for ;Zoning Clearance Clearance = OFFICE USE ONLY G, CLE # Zoning $35 Check # Date: - - `7 PLEASE REVIEW ALL 3 SHEETS Receipt # 679,::3 Staff: PARCEL INFORMATION Tax Map and Parcel: 0 S9 D 2- 61 - C) no Existing Zoning C 0 Parcel Owner: Col Aarn L.L Parcel Address: 1000 Edgann C 100 City (-,kQf 10fkSk6 �le -State \[A Zip Z2% (include suite or floor) PRIMARY CONTACT p Vl' so"e- IL R CS RLdJIG�LA Who should we call /write concerning this project? (/ P6,1 P�l� Address : o Boy- 14 6 0 g City 0-1 State VA Zip 2 � Office Phone: Cell# Fax #'f -Vl- 987--'yL2gE- mailc—kurt QVlrainia ,edV APPLICANT INFORMATION b4cA H Business Name /Type: U n i ci ^ .A P meet Previous Business on this site L u c_ k Son n&- Describe the proposed business, including use, number of employees number of shifts, available parking spaces and any additional information that you can provide: Q e nercl 44 Ce , I I - 15 e M I oLie e s ' One, 5k)-k,' 06 5•.-k IL r a e *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. Charles HvrtC---- Signatur �- Printed ASST �irQGIi7r ��'faAG� l2eGtl urn i.ver s't df V; AL APP INFORMATION [ d as proposed [ ] Approved with conditions [ ] Denied [ B� prevention device and/or current test data needed for this site. Contact ACSA, - aa�� �yy / o cal site inspection has been done for this clearance. Therefore, it is not a detenni ati bf" �jalfchdAtig r L�" urrent 1 est aLa eecdiettll site plan. [ ] This site complies with the site plan as of this date. Contact ACSA 977 -4511, x 119 Notes: Building Official Date 1 l b i 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 Intake to complete the following: ❑ YES ®IINO Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Rep (CER a ❑ YES � ort 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 p �at r? 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 OBI......._ Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑ YES ©CVO r Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # ,onmg 1 ecn to complete the iollowing: Violations: ❑ YES ❑ NO If so, List: Variance: ❑ YES ❑ NO If so, List: Reviewer to complete the following: Square footage of Use: G W [� YES ❑ N Permitted as: a m,1 11 Under Section: �'a•o1� ��� J Supplementary regulations se tion: tti 6� Parking formula: I Aa. 6 o rN Required spaces: YES ❑ NO IterrA to a verified in the fl d: u t�� Inspector Notes: Proffers: ❑ YES ❑ NO If so, List: SP's: ❑ YES ❑ NO If so, List: Date: 5/1/06 Page 3 of 3