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Home My WebLink AboutCLE200700249 Legacy Document 2014-04-28Application for Zoning Clearance jy�" -j,A,LL R 'B El Zoning Clearance = $35 OFFICE USE ONLY �,I CLE # r D6o7 4—I PLEASE RFVIFW ALL 3 SHEETS Check # Date: Receipt # 615CI Staff: PARCEL INFORMATION � /� r / L %�_ �'y �, 4 // 6 Parcel: 5 � A � - � � � Extstmg Zoning Tax Map and /"l�l� /C. Parcel Owner: C u Koh'j ,t Vas P/� V� Parcel Address: ��`�'Gt�fi«!�`�✓�r ity �0�T State \t1/ ^^ Zip-22ffl (include suite or floor) PRIMARY CONTACT Who should we call /write concerning this project? (� � I Address : J 1( 53 �T_ 6u_o � ��y�ity/ & -- State �� Zip 2� Office Phone:( �Ce11 # ,3 �iZZ� Sfax # 3q 92_'� E -mail C("6-2� 'MUs(Cf �_$"�1/al APPLICANT INFORMATION � � Business Name /Type: Previous Business on this site K a Describe the proposed business, including use, number of employees, number of shifts, available parking spaces and any (\ku S L C_ VA-L hiWN Kf' ,M additional information that you can provide: E-EST-( '-- *This Clearance will only be valid on the parcel for which it is approved. If you change, intensify or move the use to anew location, anew Zoning Clearance will be required. I hereby certify that I own or have the owner's pennission to use the space indicated on this application. I also certify that the information provided is true and accurElte to t e best of know led . 1 have read the conditions of approval, and I understand them, and that I will abide by them. Signature Printed >RUSS;P> APPROVAL INFORMATI N [ ] 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. , [ ] ith t ate. NoT (N cW � Building Official e Date 3'a Q1 — )O./ /Wo Zoning Official Date Other Official d— Date Cdunty of Albemarle Department of Community Development 401 McIntire Road Charlo^t,t� ville V 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 0 �61/ �� 511106 Page 2 of 3 7 � rJ , Intake to complete the following: ❑ YES VNO Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. U4ES ❑ NO ill there be food preparation? If so, give applicant a Health Department form. Zoning review can no in until we receiv app v I fr m�ealth 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 [P/N(0 Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑ YES NO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Goning'I•ech to complete the Violations: ❑ YES [L] NO If so, List: Variance: ❑ YES VNO If so, List: Reviewer to complete the following: Square footage of Use: ✓lam ��Z(�W%v (17th YES ❑ NO Permitted as:OlL' Under Section: 'tr Supplementary regulations section: Parking formula: Required spaces: W,,.:�v� � , L f � ❑ YES F-1 N Items to be verified in the field: Inspector : Date: Notes: Proffers: ❑ YES V NO If so, List: SP's: ❑ YES 2NO If so, List: 5/1/06 Page 3 of 3 ov AI'/ Application for RECEIVED OCT 0 9 2007 Zoning Clearance OFFICE USE LY ❑ Zoning Clearance = $35 CLE # dt� oZ y PLEASE REVIEW ALL 3 SHEETS Checl< # Date: Receipt # i GW 5 Staff: :7G-,4,4_ PARCEL INFORMATIION /' Tax Map and Parcel: ! 6A A 4 - -' Existing Zoning Parcel Owner: C L k V �>' V S C� V `__ % _?:(�� ( Ek Parcel Address: City �� State \/A Zip 20'0(9� (include suite or floor) PRIMARY CONTACT Who should — w/e�call/ rite concerning this project? /� r� / n Address : J 65- l SE 6C'o L f'�Q�ity/ C,,jj6�EC State �+ A Zip Z1� Office Phone: t Cell # . 992Z� 4ax # 7.3L 9- Z� E -mail C 6o Ot un 4es I f ad APPLICANT INFORMATION Business Name /Type: L- L� 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: m k) S L C. �-�ST-( VA- L- KC-ON �bA *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 accur to to tl a best of I knowled , I have read the conditions of approval, and I understand them, and that I will abide by them. Signature Printed 0S5 P. APPROVAL INFORMATI N [ ] Approved as proposed Approved with conditions [ ] Denied [ ] Backflow prevention device and /or current test data needed for this site. Contact ACSA, 977 - 4511, x 119. [ ] 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 compliieS with the site plan as of this date. Notes: UJ OA-1 ' %+e - ri� TSA-i3117_C- /'f f ' �` �+r1'�e�th+t �- � e�lur Building Official Zoning Official Filoz - GtiT'rr Official Date Date Date % 0 _(o—o-), County of Albeit arle 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