HomeMy WebLinkAboutCLE201500131 Application 2015-06-29Application for Zoning Clearance
CLE # `fid 1 S -- 13 �
PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY
Check # —5D-0 Date:
Receipt # 1 nC7 6 G► Staff: 435 2.
PARCEL INFORMATION
L
Tax Map and Parcel: 056A2-01-00-01800 Existing Zoning Downtown Crozet DistricE
Parcel Owner: County of Albemarle
Parcel Address: 1159 Crozet Ave, Unit A Cit, Crozet State VA Zip 22932
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? Andrew Wright
Address •826 B Hinton Ave City Charlottesville State VA Zip 22902
SIer��,��zer,�n
Office Phone: 4( 34) 295-8105 Cell Fax# E-mail cLws�u�(�? S��.Q�IJ
• CCDM
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name .f New business
Business Name/Type: Staengl Engineering LLC
Previous Business on this site A6 S tg
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:
Office use, consultina enaineers, one shift. Six to twelve emolovees
*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 to the best of m knowled e. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature PrintedAndrew L Wright
Ile
AP OVAL INFORMATION
[ Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] 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 4-4
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 3
Intake to complete the following:
Y/0
Is use in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y
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 ublic water?
If private well, provide Health Deparpar enn orm.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that a
Is parcel on septic public sewer?
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit. °,�
Permit #
Y/N1�U1,�
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning to complete the following:
Reviewer to complete the following:
Square footage of Use: 105S
'Permitted as: 9ROb
Under Section: �O 6 1 � .
Supplementary regulations section:
Parking formula: 1/1660 vl el— f 1 1c,, a rr A
Required spaces: n
Ttem. he. verified in the field-
Viol' ns:
Y/N
If so,
Prof
YIf /N
' t:
Vare:
Y/N
If so, st:
SP's•
Y/N
If st:
Clearances: A013 Ilgi fcnoM
SDP's ` "V/ n
19 1 SW
Revised 7/1/2011 Page 3 of 3