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Home My WebLink AboutCLE200700235 Legacy Document 2014-04-28Tax uinp and parcel: 6. A 1 Zoning Clearance ❑ Zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS MN� W r Parcel Owner: —A A [— (�A.-1 ) L--IV 1 11 it tip Parcel Address: 1 5( Y I i If r �I (include suite or floor) Existing Zoning: (� C — V � State Contact Person .(Who should we call /write colicertlillg fhlk project ?): T V YI Vi kAL-1 Address � � =x o'� F, CAL i _� City SV� _ State VJr Daytime Phoue "v Fax 4 l 2e E -mail Business Previous Proposed - W W' CIN1h SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet 1) Circle (if applicable): Fireworks / Christmas Tree *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 orovidtd 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 S O L H - __n4_ Date APPROVAL INFORMATION [`]'Approved as proposed [ j Approved withi conditions j Backflow device and /or current test data needed for this site. Contact ACSA 977 -4511, x 119. j 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. Building Official Date `t I I k 1 a'Z Zoning Official Date W / rZ 4� 7 Other Official V�� Date AA FOR OFFI S NLX C #, - Fee Amount 5 Date Paid M# I 1 Receipt 11 = Ck# JUQ _ By 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 oN Applicant to complete the following: Do ' have one of the following? YES [-1 NO Map p and Parcel Number and or; Address of Z�NO c ude unit or floor if appropriate) F1 YES Do you leave a Floor Plan (sketch or an architectural drawing) that includes the following, and if so please provide it with tile. application? The total square footage of the use and /or; Tile square footage of each room or area of use; Use of each roonn or area If using less than the entire structure, note the location within the structure. coning Tech to c Violations: ❑YES Ki NO If so, List: Variance: ❑ YES '�? NO If so, List: the followin intaKC LU cutllpteee Liie tuituvriiig: l ❑ YES [� NO Is use -- L , Hl or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. F/-( YES ❑ 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 14D A1pfAV'l ❑ YES Z NO Is parcel on private well and septic? 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 on public water and sewer? Z YES ❑ NO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑ YES NO Will there e any new construction or renovations? If so, obtain the proper Permit. Permit # ❑ YES Fzr NO Is this for ales of Fireworks? If so, obtain a copy of F/R permit. Permit # Proffers: ❑ YES 71 NO If so, List: SP's: ❑ YES OINO If so, List: 1 COMMONWEALTH OF VIRGINIA DEPARTMENT OF HEALTH CERTIFIES THAT Branham, Vicki is hereby granted a permit/license to operate a Fast Food Restaurant by the Albemarle Health Department in accordance with the regulations of the Board of Health, Commonwealth of Virginia. FACILITY NAME: CAFE LAJ O 1 PHYSICAL ADDRESS: 1750 Timberwood Boulevard Charlottesville, Virginia 22911 MAILING ADDRESS: 1750 Timberwood Blvd Charlottesville, VA 22902 EXPIRATION DATE: December 31, 2008 CONDITIONS: r Eric,p Myers, " Environmental H alth Specialist , Senior Please direct questions or concerns to the Albemarle Health Department, Environmental Health Services, (434) 972 -6259. This Permit Is NOT TRANSFERABLE From One Individual or Location to Another.