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HomeMy WebLinkAboutCLE200700280 Legacy Document 2014-04-28Application for Zoning Clearance pF Af.11at 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 OFFICE USE ONLY Zoning Clearance = $35 CLE # ;?66 7 oo o] 96 PLEASE REVIEW ALL 3 SHEETS Check # ':5906 Date: Receipt # 4 2116 Staff: VT"5 PARCEL INFORMATION Tax Map and Parcel: a 7e (k) - cJd " GO - © 1 7b U Existing Zoning Parcel Owner: 6/'ae--7 MP,//A- QEr't'1CA17 Ca — �6tUL fe"v ;.v-1 <�'M -r l Parcel Address: I - 0 - City C li i tl I LL ty State VA-- Zip2�0kk )% (include suite or floor) PRIMARY CONTACT Who should we call /write concerning this project? Iza P, C-&-r "L-re; Address: x-22 ed P LA-n- 19--+, 6e- AK City 0_ if'U I LLB State V^_ Zip?2 L9 It Office Pltone: (�i l) 2 6--58 Cell # `(G2. -G-74c Fax # E -mail AC Gti9r'� �"re>;s CAL-M AP_ur - CAI APPLICANT INFORMATION Business Name /Type: /l, o-4 Cc v A z s Previous Business on this site Describe the proposed business, including use, number of employees, number of shifts, available parking spaces and any additional information that you can provide: f-A-c a- dl=' C( -V f''� n► c2e2�s t(12_110-7 f% f Lr 2`i1�7 *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 4r6e- T --7-. &14-- L- -1i-" APPROVAL INFORMATION [ ] Approved as proposed Approved with conditions [ ] Denied [ ] Backflow prevention device and/or curren 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 site complies with the site plan as of this date. Notes: Building Official ���- +- -�-� -- Date 1 f l a°3 /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 5/1/06 Page 2 of 3 Intake to complete the following: ❑ YES X NO Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. ❑ YESZ 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 public w er? 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 o,pu er? YES ❑ NO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # -r4 0-7 /?3 Z ❑ YES 2rNO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Loning '1'ech to complete the Violations: ❑ YES ❑ NO If so, List: Variance: ❑ YES ❑ NO If so, List: Reviewer to complete the following: Square footage of Use: v y a FT YES ❑ NO J Permitted as: "pea »✓A / 5.91 �-' Under Section: /��__ ,�4'✓i��'C� i Supplementary regulations section: Parking formula: <�-�- ��� 1 Required spaces_- ❑ YES NO Items to b verified in the field: Inspector : Notes: SP's: ❑ YES ❑ NO If so, List: Date: 5/1/06 Page 3 of 3