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Home My WebLink AboutCLE200700097 Legacy Document 2014-04-28r'} Application for Zoning Clearance =I= J •�V OFFICE USE ONLY �} 19 Zoning Clearance = $35 CLE # Z OO7— _/ PLEASE REVIEW ALL 3 SHEETS Check # 91S 3 Date: / , 67 Receipt # 69-515::1 Staff: C6 PARCEL INFORMATI N lY- NMD Tax Map and Parcel: b(o � 00 - 00 ° ODOC � Existing Zoning Parcel Owner: 5 [t GAIZ� q ` l c, Lt, Parcel Address: T4 I McWWO06 -9MO I n4W City CHM V be State (include suite or floor) 6Vl k4 JO l Aiv%c 10q- vA Zip 22 O� PRIMARY CONTACT r Who should we call /write concerning this project? �� ©� �1�12 l LLC. Address : (oqf� E)6JLte_KA_a G 12 • city CAA' V 1 LUG- State VIA - Zip Office Phone: 0179 8 t1(o(o Cell # Y34 P- 4 - Fax # L13L4 diet S E -mail tlft L' QN 352-x- ot�8 tl . APPLICANT INFORMATION Business Name /Type: CW15;�6 O 77 7267 ZAJ6VAO_NOE GO Z O�i-r:IGe3 Previous Business on this site NON Describe the proposed business, including use, number of employees, number of shifts, available parking spaces and any additional information that you can provide: —117LE CO 0 F-F IDES : EKdP W 4Ye7e-S : et S:LA� S LN C1S : O -Ate P -P_141 IV l : / O F_ 12- 2OnSO UA4Z_P__' FG_ A= T- f9 F 6PF1 Cg ADge *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 APPROVAL INFORMATION G Ez;,1za E W • t24L C Y - e. d 7 05e . [ ] Approved as proposed [ ] Approved with conditions [ ] Denied [ ] Backflow prevention device and /or current test data needed for this site. Contact ACSA, 977 -4511, x119. [ ] 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 Zoning Official Date Z� i11 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 r Intake to complete the following: ❑ YES []'NO Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. ❑ YES [ENO 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 ❑ NO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.�� S Permit # 4NLLf AYES ❑ NO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # 132. D 0 50 5 to 0 7 N C (F-0 F— V3 L,7(?, �D►2 � N i rs = �E�YU �� Reviewer to complete the following: Square footage of Use: o�$� CZ YES ❑ NO Permitted as: (�&j Under Section: �oj Supplement y regulations section: -1,n I f 0 , Parking fo i ula: /r�A I/� o kv` Required spaces: VI ❑ YES ❑ NO Items to be verified in the field: P-5- `� ,►�- ,1 -�sv� Inspector : Notes: Date: Zoning Tech to complete the following: Viol •tions: Prof ers: YES F-1 NO [� YES ❑ NO If so, List: If so, List: vco20nA��( ALdeL Oo -- ( cvb Variance: SP's: ❑ YES ©ENO YES ❑ NO If so, List: If so, List- 3P �� 3 5 � t5 IML511106 Page 3 of 3