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HomeMy WebLinkAboutCLE200600297 Legacy Document 2015-02-10Application for. Zoning ' . a1 ' OFFICE USE ONLY n Zoning Clearance = $35 CLE # Cie -z CQ 1" — Z9 —7 PLEASE REVIEW ALL 3 SHEETS Check # ;3 C4 5 Date. /a Z ' -O Receipt # la123,& Staff: PARCEL INFORMATION Tax Map and Parcel: _ 0 6 ( Gc) C) —(D3 m o --© l goo Existing zoning Ll &kI r J VUO L) S , /li AL- Parcel Owner: S CM 1VV0 t"- --7—,11,,A t(, t- 0461:-015 S [�L Parcel Address: //90 5eM(1\fo� i n✓{ City Cf( �wT jUJU, State Zip �;L:"L o (include suite or floor) PRIMARY CONTACT Who should we cali/wrlte concerning this project? 2� t Sit 44- !' Address: 1 D � � r b tc ( City Dries (2,61" 1 I u State VA 4-210i_ Zip S-11 Office Phone: 3`I g` 7 2'l�2� _3 D Z `/ 2 (� Celt# Fax# 047 E -mail CSh�►ci)onts� a see wr i # , ez•r -, APPLICANT INFORMATION /� Business Namefrype: 44rg, 04 St CAAli {-� Sa Li 0,�e S, ' h c . Previous Business on this site_ _ C 6 M l (- (�✓ ��Fl % Jam^ t� r�/L�'ec15�(/ (r .� yf�c Describe the proposed business, including use, additional information that you can providT. *This Clearance will only be valid on the parcel for which it is approved. Ifyou 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 ttue 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 ahem. Signature OK. e c G — Printed C.,00 S ':6 Ze VI h -t ) APPROVAL INFORMATION Approved as proposed E467i7r��j p p [ ]Approved with conditions �ackflow prevention device and/or current test data needed for this site. Contact ACS � [ No physical site inspection has been done for this clearance. Therefore, it is not a date ' $fie site plan. [ ] This site complies with the site plan as of this date. Notes: Building Official Date C. Zoning Official �� Date 6 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 Intake to complete the following: ❑ YES ❑ NO Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. ❑ YES ✓['NO 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 2'NO Is parcel on private well public wate ? If private well, provide e th Depa ent form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE [YES ❑ NO Is parcel on septic o public sewer ❑ YES E?(NO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑ YES VNO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Gon1ng 'Tech to complete the [YES ❑ NO I s�List: J J Pn Variance: ay O If so, List- Reviewer to complete the following: Square footage of Use: 1939 Bi YES ❑ Permitted as: b $5 "9111'a GG Under Section: I Ll • A - 10 4—) Supplementa regulations section: A . c Parking forynula:_ r Required space *Mw ❑ YES NO Items to be verified in the field: Inspector : Date: Notes: Proffers: ❑ YES [j4 NO If so, List: S s: YES ❑ NO If so, List: GP-M(A - �?I 5/1/06 Page 3 of 3