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Home My WebLink AboutCLE200700291 Legacy Document 2014-05-06Application for Zoning Clearance }�J:ir riii �Y da•�i\ .r...;� :�.:. Zoning Clearance = $35 OFFICE USE ONLY CLE # M7 Check # '7 Date: PLEASE REVIEW ALL 3 SHEETS Receipt # ` a Staff: PARCEL INFORMATION Tax Map and Parcel: 0(0 (p tq - 07-1 -- 00 �- O ( � 00 Existing Zoning % "\A1 Parcel Owner 5zVy ,l f t�J•� -�:. 7'_ rnn_CJ n Parcel Address: Jk bO �'e+�tr �`C� - City C[' C ,104e, (fj6ate Vk Zip 2 (include suite or floor) `te_ 4-q5 PRIMARY CONTACT ' I'� ' Who should call /write concerning this project ?�¢ Y b `\ l�,G f�rwe Address : City �� State Zip (_ Office Phone: � ell # �3A Fax # 01- 6-7Z2_ E -mail APPLICANT INFORMATION Business Name /Type: T1r \� �— �- C, 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: .D - ," CRA r 6e060C -SW---,0E , *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 APPROiAL INFORMATIONy" /] 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 t ,zi Zoning Official Date _/Zz ZZ 7 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/l/06 Page 2 of 3 Intake to complete the following: YES ❑ NO Is use in LI, III or PDIP zoning? If so, give applicant a Certified Reviewer to complete the following: Square footage of Use: 2 -7 ):K Engineer's Report (CER) packet. YES ❑ NO j Permitted as: ❑ YES 9<0 Will there be food preparation? Under Section: If so, give applicant a Health Department form. Zoning review can not begin until we receive approval from Health Supplementary regulations section: Dept. FAX DATE in, I C, use` L ❑ YES D40 Parking formula: # e y' • 2 Is parcel on private well or public water? = p,?c J� T Required spaces:— ❑YES /Z NO Items to be verified in the field: ❑ YES ONO Will there be any new constriction or renovations? If so, obtain the proper Permit. Permit # Zoning Tech to complete the following: Violations: Proffers: ❑ YES Z NO ❑ YES �� NO If so, List: If so, List: Variance: SP's: ,,© YES ❑ NO 0 YES ❑ NO If so, List: f� y� If so, List: J A �, ✓ 1, �� y�� 5/1/06 Page 3 of 3