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CLE201200022 Legacy Document 2012-02-06
,MIN Application for Zoning Clearance oe nt1�,t =t; CLE # I `� `^ :4 0`''`; �irrcnN�r OFFICE USE ONLY PLEASE REVIEW ALL 3 SHEETS Check # �Z � Date: Receipt# Staff: /4 PARCEL INFORMATION Tax Map and Parcel• �� 3 �j Existing Zoning h 1 y /? Parcel Owner: 8266,g col - & Parcel Address: �b0 fl-d, Sl [o_w /City 011 g V_zeh State Zip (include suite or floor) PRIMARY CONTACT Koh Who should we call /write concerning this project? e' h � � Address: 36b (— (jrlcly,vs City a"66pAU�6 State V Zip Office Phone: CW Cell ax# E- mail - 56(.igr_t1: "w,bLi.Slrn'<SS APPLICANT INFORMATION Check any that apply: Change of ownership _ Change of use of name New business ^ /Change Business Name /Type: &,o I`� J� e, i U an- i Previous Business on this site v cf:!7 Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of vehicles, and any additional. information that you can provide: 0� �5i u S D�ri c� F�l �ll�U 120�f� S% *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 t th best of my knowledge. 1 have read the conditions of approval, and I understand them, and that I will abide by them. Signature Printed APPROVAL INFORMATION as proposed [ ] Approved with conditions [ ] Denied ]Approved 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 of this date. Notes: Building Official Date i )- Zoning Official Date L�✓7�l 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 it 1, Cc(, per rIntake to complete the following: Y/U Is use in LI, I-If or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Reviewer to complete the following: �S,q\uare footage of Use: 9 0 v/ N l �1 CR, Permitted as: � � ,' „ Y /, � 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 Circle the one that applies Is parcel on private well of — tayrtment ater? If private well, provide He form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that a Is parcel on septi is ? Y/N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Y/N Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # 7..,,I t iota tlia fnllnwina- Parking formula: Required spaces: Y/ Item to be verified in the field: Inspector: Notes: Date: Violations: Y/ If so, ist: roffers: /N so, List: Val' nce: (N) If o,Zist: SP's- Y / . If so, List: Clearances: SDP's Revised 7/1/2011 Page 3 of 3 § y ( § ) / InE` \ Z ¥ . ~ ©i GNP ° j�� �L')m � 2 °2 '7 - 1p `� [ U 7 I\j 2 < E nC/) %,2\ \2§ HLJm G °' . 0 § \© \ m% /\ .D m . e \ \ Z. oa \q/ /0{ ! 0 A m B - \S\ e 1 -n � \ \ � D q § � � � Z ¥ . ~ ©i GNP ° j�� �L')m � 2 °2 '7 - 1p `� [ U 7 I\j LLLIJ \ \ \ 2.a co \2§ . \» G -n- \ § | .D m \ %\ e � { oa /© /0{ ! A m B - / e Z � \ \ � D q § � � \ � �k7\ 0 _ co > 71 m�I @ , 0 > CA I `� [ 0 m r $ 02 mI §9m \ \ \ 2.a . \» G \ § | .% m }/ / { oa /© ! //. B - / >$ \ \ Zoning Clearance Checklist Applicant MUST HAVE the following information to apply for a Zoning Clearance: 1) Tax Map and Parcel or Address, Building Name, Suite/Unit /Floor numbers, if applicable. 2) A Floor Plan_- either a sketch or an architectural drawing a) --If using -less- than -the- entire_ structure; -note the location within the structure; -b)- -Note the total square footage of the us- e_' c) Note the square footage of each room or area of use;, d) Note the use of each room or area of use. 3) Certification that notice of this application has been provided to the property owner, if owner is different from at)plicant. FEES Zoning Clearance = $50 Temporary Fundraising Activity = No fee Conditions of Approval FIREWORKS: 1. No person shall sell, offer for sale, store, display or discharge any fireworks in any filling station or on any premises where gasoline or other inflammable liquids are stored or dispensed. (Code 1967 10 -13.) County Code Section 6 -200 and 6 -300 and must be a minimum of 100 ft from any gas pumps /propane distribution tank. 2. The site shall be cleaned and restored to its original condition on or before July 11th. This shall include removal of all structures, signs, debris, and the like. 3. A thirty (30) foot front setback shall be maintained, Display shall be located so as to avoid traffic congestion.. Modifications subject to Zoning Administrator's approval. ° 4. Building permits shall be obtained_ for all proposed structures and /or lighting. 5. Sign permits shall be obtained for all proposed signage. 6. The sale of fireworks requires a special permit from Fire /Rescue department. CHRISTMAS TREES: 1. The outside storage of combustible material or flammable materials shall be located so as not to constitute a hazard and shall not be less than 15 feet from any building on the site. Any open burning must comply with the Virginia Statewide Fire Prevention Code and the Albemarle County Code. 2. The site shall be cleaned and restored to its original condition on or before January 2. This shall include.the removal of all structures, signs, debris, and the like. 3. A thirty (30) foot front setback shall be maintained, Display shall be located so as to avoid traffic congestion. Modifications subject to Zoning Administrator's approval. 4. Building permits shall be obtained for all proposed structures and /or lighting. 5. Sign permits shall be obtained for all proposed signage. OTHER REVIEWS: 1. Is the property on public or private water /sewer? Private requires Health Department, Public requires ACSA review (2 to 5 days) 2. Will you be operating a bakery? USDA review is required (approx. 2 weeks but as long as 6 weeks) 3. If you are serving prepackaged baked goods but not making them on the Premises, only Health Department will review. (2 to 5 days) 4. If you will be operating any business that is in an industrially zoned district or of an industrial nature you will need to provide a Letter'of Performance Standards ,or Certified Engineer's Report (a staff member will provide an information packet addressing this requirement) (5 to 10 days as soon as the Letter or Report is received by this Department) 5. If there has'been no site inspection within the last three (3) months for the parcel /site, then one will be conducted to verify that the project is in compliance with an approved site plan (if applicable). 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