HomeMy WebLinkAboutCLE201200114 Legacy Document 2012-05-30n n /1 _ I — A
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
5J 7Y
Application for Zonin/ Clearance�;'��'''
CLE # L O 2 -� I mot" :_, •A ", ,t-
OFFICE USF,, ]Yk y
# 1�' !'
PLEASE REVIEW ALL 3 SHEETS 7Receipt#—
Check Date:
Staff: I`<L� (/
PARCEL INFORMATION of
pt
y5o� - DO - Go- 165 d G Existing Zoning 6 (Y)Ajif ri~ ofpt ce
Map and Parcel: _�
Parcel Owner: t11�111^r.r'°
r
Parcel Address: b `� ��lf� 910 pd, city � t t�' f'�� °� State �) �— Zip
(include suite or floor)
PRIMARY CONTACT
Cc ri`F }"� �. sm 1��1
Who should we call /write concerning this project? - •
Address: (C 10 VJ( jk Ck r'� t r'. City (.h CAjO +- rcS/1l t State �j Zip -219 01
n
Office Phone: CqN) 27-0 173� Cell # Fax #'13117 73 E -mail
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name 1/�New business
Business Name /Type: V 1Cf� C�. ✓� �1C�ii('r� F `( L/-t -L
Previous Business on this site 'k—ee, t ct0 �� t°%�T• !�
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
vehicles, and any additional information that you c n provide: "� tai._ of
Pa.(� _�trY ,n �,t ?? l,' isa�c,.e_r� %'H V-,I'l , 0-,1
*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, ave the owner's permissio to use the space indicated on this application. I also certify that the information provided
is true and accurate to e st of my wled hav lead the nditions of approval, and I understand them, and I will abide by them.
that
Signature Printed C5U cf�i /
APPRO INFORMAT N
Appro d as proposed I., [ ] Approved with conditions [ ] Denied
ACSA, 977
[ ] Backflow prevention device and /or current test data needed for this site. Contact -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:
I' 6
Building Official ? Date ��/
//-a-((.
Zoning Official / 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
5J 7Y
Intake to complete the following:
Isin LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y /a Will ere 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 tbli�, r?
If private well, provide He Ith nt form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that appli
Is parcel on septic o ublic e .
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 #
Zoning to complete the followinL,:
Reviewer to complete the following:
Square footage of Use: %Jr 2 C7
�y/N
Permitted as:
Under Section:
Supplementary regulations section:
Parking formula:
Required spaces: i
Y / �i
Items o be verified in the field:
Inspector : Date:
Notes:
Viola�f��ons:
Y /�N)
If so, ist:
Proff rs:
Y/ IO
If so, List:
Varia ce:
Y/0
If so, List:
S P's:
1' u
If so, List:
Clearances:
SDP's
Revised 7/1/2011 Page 3 of 3
Application for Zoning Clearance
Attachment 1
The location is occupied by Hammer, C.D. (Alb. Co. Bus. Lic. # 0504464) and parts of 3
departments of The Resorts Companies, Inc. (developer of Massanutten in Rockingham
County).