HomeMy WebLinkAboutCLE201200017 Legacy Document 2012-02-07• • •
Application for Zoning Clearance
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CLE # 0O (Z —
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PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY
Check# q51 Date: 1-26'12-
D Staff:
Receipt #
PARCEL INFORMATIOI_ .� n
0<5-69 J 0 .00 -0'7 O `� 3if d Existing Zoning M D
Tax Map and Parcel:
Parcel Owner:
�i State Zip Z6 0
Parcel Address:—/ ! Cl!(ilocrl7 `D�A_ . Cit3 ti�j���
(include suite or floor)
PRIMARY CONTACT
this project?
Who should we call/write concerning
n
Address : L. 2 Y -Td. Zip .
Office Phone: L_) 79-7i Cell # -- Fax # E -mail
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name /Type: J B c� 'c ' G
Previous Business on this site /4 D '� P_
Describe the proposed business including use, number of employees, n tuber of s its, ailable a n spaces, nu er of
vehicle and an�dditi nal info m tion thpt you can ovide:
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*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 ave the o er's permission to use the space indicated on this application. I al o certify that the information provided
k ledge. I have read the conditions of approval, and derstand t m, and that I will abide by them.
is true and accurat of my o
rI
Signature _ Printed 0�-C
APPROVAL INFORMATION
>c,] Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Baclflow 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 detenninaf ion of compliance with the existing
site plan.
[ ] This site complies with the site plan as of this date.
Notes:
Building Official r Date
/
2-/
Zoning Official Date
Other Official Date
County of Albemarle Impartment of Uommumty MeveiopmenL
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 7/1/2011 Page 2 of 3
Intake to complete the following:
Is/
Is u LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y/ r ;
Will t re 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 applies
Is parcel on private well or eepaFent ?
If private well, provide Healt 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 blic sewe
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 # g fir) 1,
Zonin to com lete the following:
Reviewer to complete the following:
Square footage of Use: Z37�% �'us�, --,4L n &C ? N
N l7arifted as: �b cYr.( M-e , Z,4 G <. • !.(. $ ¢--
Under Section: W i a d Lq q�
Supplementary regulations section:
Parking formula:
Required spaces:
Y /OI
Items to be verified in the field:
Inspector : Date:
Notes:
Violations:
/N
If so, List: L
ffers:
N
so, List: /
zl-
Vari ce:
Y/
If so, List:
SP's:
Y/
If so, List:
Clearances:
SDP's
Revised 7/1/2011 Page 3 of 3
C .,
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the
owner.
I certify that notice of the application,
--WzviZ- . 17
[County application name and number]
was provided to o. - S the owner of record of Tax Map
[nam (s) of the record owners of the parcel]
and Parcel Number
manner identified below;
by delivering a copy of the application in the
Hand delivering a copy of the application to
[Name of the record owner if the record owner is a
person; if the owner of record is an entity, identify the recipient of the record and the recipient's
title or office for that entity]
on
Date
Mailing a copy of the application to
[Name of the record owner if the record owner is a person;
if the owner of record is an entity, identify the recipient of the record and the recipient's title or
office for that entity]
on
Date
to the following address;
[address; written notice mailed to the owner at the last known address of the owner as shown on
the current real estate tax assessment books or current real estate tax assessment records satisfies
this requirement].
Sign of Applica
A r4 O., kv
Print Applicant Name
Date
Cunt of Albemarle Us, L02'�
BUILDING APPLICA77ON -Page 1
s���aa���oo` �urrenl
TMP O wners)
Acres 0.991 Primary Zoning Neighborhood Model DiStrict
Community CJeavelopment nepaitnient
401 McIntire Road Charlottesville, VA 22902-4596
Voice ; (434) 296.5332 f =ar, ' (434) 972-4126
Major Subdiv.
Application # B2011- 01567 ^SFT ✓r +! ?"i. I Entered fay; Judy Martin on 081101 ?_011
it • Associated Building
Sub Application Type Single Fainily'Townhouse Permit
Street Address:
Work Class Frame Type Water Supply Type�T Sewage Disposal Type Foundation'1 ype
New Wood Public Public
.........................
E�aser)Zeni;
work Valuation Jurisdictional Area Other Foot / Found. Desc.:
�o ®9 Water° & Sewer �— — - = -- - - - - -�
Work NLtiU Si:Nf;ll i F�AP� ILV TOWNHOUSE
Description:
Directions 11 ICKRIAM POND •- SEA;. 7 - PH 2 -• LOT 93 - 146S @1 ICKHAM POND DRIVE
Legal i11 ICKHAM POND 7 93 Pl-1 7
Description:
Use Group (Unknown Construction Type
Square Footages: :# of Stories Porches 794 Unfinished Basement
1st Floor Decks 1G0 Other Unfinished
2nd Floor 64•® Garage X83 Total Unfinished Sy. f3
Footage
3rd Floor Swimming Pool
Finished Basement 457
Other Habitable
Total Habitable Sq. Footage G.�3� Total Btllding Sq. Foota4le 7374
C�Set Backs:
Front �(it
Left Side
('�
Back
Right Side
t
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`I y
Tubs \Spas (Res. only)
Zoning Pre - Construction( t
Fire Alarms Required?
Fire Sprinkler NAPA Code /Year C
:• j ,r
f��
Dwelling Units E::� Accessory Structures Mobile \Prefab. Homes
Carports Bedrooms F 3] Baths 3
Garages a. I<I,tchens
Other Elevators \Escalators \Llits
LElnu USCr 1
Bldg Pre - Construction? (�
Mobile Offices \Prefab, UnILS
Paint Spray Booths
F1
Swlnuning Pools \Hpt
Tubs \Spas (Res. only)