HomeMy WebLinkAboutCLE201400107 Legacy Document 2014-06-13Application for. Zonln(r 'Clearance
2L
CLE, # 14 -
OFFICE U WELY
PLEASE REVIEW ALL 3 SHEETS
Cliecic# Date: UC
Receipt # Staff.
PARCEL INFORMATION
Tax Map and Parcel: D Existing Zoning ('1) 611 f Y) clr,✓ - 1- L-e
ParcelOwner: of Ujr"J/
Pax-eel Address: is Hii--fYIJ L-bl city I-UL-1111115'ill 1/. State zi[) 4 _011%0
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? U
Address; ( i city r/68nir/N state vil Zip
Office Phone: (k)!itr) 11 o' 1 27- cell -H Fax # E-mail 61, fNI 1'h c"
APPLICANT INFORMATION
Check any that apply: —Change of ownership _Change ofuse _Change ofname 1,, New business
Business Name/Type; -'a"ar) Li Li, 1 Ln
Previous Business on this site
Describe the proposed business including use, number of employees, number of shifts, available parldng spaces, number of
vehicles, and any additional information that you can provide: CpykeYatt cdhp • wd Lj-c2
cfop (mlo-C Mlk —eJyg. Roo ee&A, -yn po-bWo Ige r_ ffft)pi-fae. &Q,
*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, a new Zoning
Clearance will be required.
I hereby certify that I own or have the oNmer's permission to use the space indicated on this application. I also certify chat the information provided
is true and accurate o the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature :1-AW –24A& Printed— YUE 2-H U
APPROVAL INFORMATION
Approved as proposed Approved with conditions Denied
Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, x117.
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 oC this date.
Notes:
Building Official Date
Zoning Official Date ILI
Other Official Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
Revised 7/1/2011 Page 2 of 3
ed u
F.
Intake to complete the following:
Y/N
Is use in LI, HI or PD1P zoning? If so, give applicant a Certified
Engineer's Report (CER) packet. LY„/
Y /
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
Circle the one that a lie
Is parcel on private w 1 or public water? .
If private well, provide Hea th Depai ent form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applies
Is parcel on septic or ublie sewer?
Y /i
Wil y ou be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y /§tere
Will be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning to complete the followine:
Reviewer to complete the following:
Square footage of Use: _40
Y/N
Permitted as:
Under Section: L �f �.
Supplementary regulations section:
Parking formula:
Required spaces:
Y/I
Items to be verified in the field:
Inspector:
Notes:
Date:
Violations:
Y //
If so( tst:
Proffers:
Y
if s "st:
Variance:.
If /,, id�
Ifs , ist:
SP's:
If ,�Nl
If , 1st:
Clearances:
SDP's
Revised 7/1/2011 Page 3 of 3
EXHIBIT "A"
Attached to the Lease Agreement between the UVA Foundation and Tralin, Inc. dated , UjULl ? /,?o I
PREMISES FLOOR PLAN
Li
Suite 119, 121,129, 1 Boars Head Pointe