HomeMy WebLinkAboutCLE201300085 Legacy Document 2014-08-21{
OFFICE USE ONLY:
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CLE # i����/., 1-5
Zoning Clearance = $35
OFFICE USE ONLY r�
Cam# L " �� Date: �` r✓� ���
PLEASE REVIEW ALL 3 SHEETS
Receipt # q1dqV,,Q Staff: 1,167 M
PARCEL INFORMATION /�!1
4460 -00 ' ��
Tax Map and Parcel: VV Existing Zoning
h(�wSu �l�Y
Parcel Owner: 1 (/ /� �t✓C/
Parcel Address: i 57a R; n RyAS GJe5� City &111' oillSde-State VA Zip 2--1 20/
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FARMER / PRIMARY CONTACT
Are you an owner /lease of farmland in Albemarle County? Yes
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Who should we call /write concerning this project? ✓C'
Address: / i C 0v �T City C-11 is T IT' r '° big State L/A Zip Z
Office Phone: Cell # °Z 3 / — G
Fax # E -mail S�e`� 2 ti y►1 i4Gy , �lQ 5�1
Check any that apply: Change of ownership Change of use Change of name New use
APPLICANT INFORMATION
Market Name/Type: &i1 Ai.. M'; C.n 1Aui S lA L 2� in �-
Describe the proposed business including use, number of vendors, available parking spaces, and any additional 'information
that you can provide: OAi t- _5 A I Di.1
*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, or if the
applicant information changes, then anew Clearance will be required. The applicant is responsible for compliance with this approval, as well as any
other necessary approvals from other agencies (Health Dept., Dept. of Agriculture, VDOT, etc.)
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
lede I understand the conditions of approval and I will abide by them.
is true and accurate to the best of m7v
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Signature Pr nted �,�Q✓ �? ti V-1A K;Fk.
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APPROVAL INFORMATION
Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] 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.
Additional Notes:
Building Official Date `5/�Lh 3
Zoning Official Date121 I2L)/
Other Official Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Page 2 of 3
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Intake to complete the following by circling all that
apply:
Is parcel on private well or private septic? Y / N0'
Will there be any food preparation on -site? Y /ON
Reviewer to complete the following:
Square footage of Use:
Permitted as: B-.4&JV VAS o
'/
Under Section: 7 2.�_. 1
If so, inform the applicant that Health Dept. approval Supplementary regulations section:
may be required before final approval of this
application. Parking formula: /
FAX/EMAIL DATE TO HEALTH DEPT. !/„ �,���� +•
Will there be any food preparation off -site, includinger4 Required spaces:
baked goods, jams /jellies, salsa, etc.? Y, NN
Items to be verified in the field:
If so, inform the applicant they may need to contact the
Dept. of Agriculture for any necessary approvals.
FAX/EMAIL DATE TO VDACS
Will you be putting up a new sign of any kind? 0/ N
If so, obtain any applicable sign permit. Inspector : Date:
Permit #
Notes:
Any new construction or renovations? aY / N
If so, ob ' the nec s , y ennit.
Permit #
Zoning to comnlete the following:
Violations:
Y /A
If so, ist:
Proffers:
Y /(R
If so, ist:
Variance:
Y16)
If so, List:
SP's:
Y/
If so, ist:
Clearances:
SDP's
r:dited:5/ 11/ 1 U
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