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HomeMy WebLinkAboutCLE201200038 Legacy Document 2012-04-04Application for Zoning Clearance PLEASE REVIEW ALL 3 SHEETS OFFICE USF,, ONLY Check # 12Cv Date: Receipt # Staff: PARCEL INFORMATION n,� Tax Map and Parcel: H 6 S .-I " C`702 R Existing Zoning Parcel Owner: JA.1 (y y-LEacl Prof,' CSAe y- L l.. c Parcel Address: A � V .L^N.vUbe to-(_� ems. City u,' State L/A Zip (include suite or floor) C J L_z_z Le 1,S " I q 9 1 PRIMARY CONTACT (l� Who /write 1+0 1 +o should we calf concerning this project? � `' \°� n- Address : R o . go x R t LC% City State U-7/4 Zip 22 Office Phone: CL 379-FISI Cell# Fax# .9-94, 96-ID E- mailSfe=.ye,,ouirgru;tk (LILCC( �r�a�/IG,i -:.- APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name ✓ New business ,,//�� R l Business Name/Type: t'-c PI GNi (C A fin- rk alml L-LL9 PL / Previous Business on this site Describe the proposed business including use, number of employees, number of shifts, available parkit spaces number of �r� S•f-a_ �R I. vehicles, and a�}y additional information that you can provide: _v�•�ec� , i-z - 52 „n y -- �I.`.�� l - ©►tip ��i.�,°� f- Past__ wg ,����s ,D.^r�ir,`d�d *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 aMto e bes t of my knowledge. I have read the nditions of approval, and I understand them, and that I will abide by them. Signature QLA IL Printed �%�� l�l�L N /74 . PROVAL INFORMATION' Approved as proposed] Approved with conditions Denied [ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 97.7 -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 Z� Zoning Official 41e, '? Date 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 , C*O a+, Intake to complete the following: Y /NQ Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y/(F) 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 Reviewer to complete the following: Square footage of Use: % /N Permitted as: Q f j (Ju (".4 e, Under Section: - a �• Supplementary regulations section: Circle the one that applies Parking formula: Is parcel on private_well o ublic water? If private well, provide Health Department form. Zoning review can not begin until we receive approval from Health Required spaces: f/ Dept. FAX DATE Circle the one that applies Is parcel on septic o ublic sewer? Y /(E> Will you be putting up a new sign of any kind? Sign permit. Permit # Y/N Items to be verified in the field: If so, obtain proper Inspector : Date: Y /(B Notes: Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Zoning to complete the following: Violations: Y /(� If so`, List: Proffers: Y/ If so, ist: Varia ce: Y/U If so, List: SP's• Y/ If so, ist: Clearances: SDP's Revised 7/1/2011 Page 3 of 3 02/22/2012 15:02 FAX The-oftms to be occupied by Arnica Farm Club sEafthrg February 27'' 2W at 2524 kmmnce lane, Suite B, Chario e, Y-wginia 22921 shah be used to condtKI professional and administrative office duties only. said oftes will not be utiiited to conduct padugln , warehouse storage, or retail shipping activities. Caesar Layton President, Arganica Farm' Club Date: 2' 2.1- t . IM 002/002