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HomeMy WebLinkAboutCLE200600269 Legacy Document 2015-01-21p6 -26q Application for, ' °�` "`'� Zoning Clearance k: OFFICE USE ONLY / [2 (zoning Clearance = $35 CLE # Z © L% 11) L lSC PLEASE REVIEW ALL 3 SHEETS Check # 1 Date: 1- `! - O !B Receipt # fa�SSj.> Staff: 9 PARCEL INFORMATION Tax Map and Parcel: 669 , - Z Existing Zoning_ Parcel Owner: YI D (1 2 S e 71V jr 1� vJ s1 L —o, Parcel Address: �?Z 5 TOO r Le.;r City ChAr J D-VteSV4 1 State /T ZipzZ z? (include suite or floor) PRIMARY CONTACT k� , l VI 'l yVn raV1 i v� Who should we call/write concerning this project. Address • q2-7 &r4 y� bjT �i City C-react State Zip _ZZ'q _j ;_ Office Phone: 4;� . '9Z 7 ell # 'W -Za L0 Fax # APPLICANT INFORMA' Business Name/Type: Previous Business on this site 17 o /'7 e- E -mail Wl-fl'rank /: ( Describe the proposed business, including use, number of employees, number of s ifts, available parking spaces and any additional information that you can provide: � c7 �� ��, y d0 ie w w Z ene o e Z. *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. l Signature Printed `�Uf h rst __%rl �l 1116 APPROVAL INFORMATION [ ] Approved as proposed [ ] Approved with conditions _�-- [ ] Denied [� ackflow prevention device and/or current test data needed f thig ekiF AAt VS,ALL 9�7-51 1, x119. [No physical site inspection has been done for this clearance. �reettis�t�ation ,pf compliance with the existing sir site plan. Contact ACSA 977 -45 11, [ ] This site complies with the site plan as of this date. Notes: Building Official Date i I Zoning Official Date II lT� b Other Official Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 5/1/06 Page 2 of 3 Intake to complete the following: ❑ YES M/<0 Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. ❑ YES [D "O 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 ❑ YES 0,N6 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 ES ❑ NO Is parcel on septic or public sewer? ❑ YES MAO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑ YES [9 NO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit# 13 a 00C,` d4 -q 1AL 13 ao4. 0G n 0 t F.OvA Coning 'l ecin to complete the tonowina: Vi ations: YES ❑ NO If �o Dist: 3 — 1 v Variance: 0 YES 52/NO If so, List: Reviewer to complete the following: Square footage of Use: i �53 5 112/YES ❑ NO �� p \ Permitted as: 0 •J��J"4Cf, nn / Under Section: 2-6Aa_ t) 4- OA, a A L ((� Supplementary reguiat Ma section: Parking formula [c, Required spaces: ❑ YES Z NO Items to be verified in the field: Inspector : Date: Notes: 7 if UA So Proffers: 1D YES ❑ NO If so, List: R G ,� (►J�MIUU/� YN���?� •", ' EYES ❑ NO If so List: c 511106 Page 3 of 3