HomeMy WebLinkAboutCLE201500139 Application 2015-07-13Application for Zoning Clearance
4
CLE# tS-C 1
kl
y. "
t rttctN�'"
OFFICE U�EONLY
Date: q
PLEASE REVIEW ALL 3 SHEETS
Check#
Receipt # Staff: v�—
PARCEL INFORMATION ;l
Tax Map and Parcel: 06100-00-00-027CO Existing Zoning
Parcel Owner: CARR WOOD PRODUCTS LLC, C/O MANAGEMENT SERVICES CORP
Parcel Address: P O BOX 5306 City CHARLOTTESVILLE State VIRGINIA Zip 22905
(include suite or floor) 2 I d "AL 103
PRIMARY CONTACT
Who should we call/write concerning this project? ASHWATI RAMCHANDRAN NAYAR
Address : 935 Bing Lane City Charlottesville State Virginia Zip 22903
Office Phone: (_� Cell # 434-249-2888 Fax # E-mail charlottesville@aloha-usa.com
APPLICANT INFORMATION
Check any that apply: X Change of ownership Change of use Change of name New business
Business Name/Type: BASE4G LLC d/b/a ALOHA
Previous Business on this site Ayishi Inc. '? 61MJ!4 ,4 WVIA))&p
Describe the proposed business including use, number of emplo ee nu ber of shifts, available par King spaces, numbb`er of
vehicles, and any additional `Yinformati n that you can provide: IO
Y1M >1'�S
*This'Clearance will only bd valid on the parcel for which ie 3 apprDked. 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 my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signatur4 1, PrintedASHWATI RAMCHANDRAN NAYAR
APPOVAL INFORMATION
[ pproved 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 Z
Zoning Official 6 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
Is us m LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y/N
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 o public wale .
If private well, provide Hea epar ent form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applie
Is parcel on septic o public sew ?
Y (\N
WilI you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y
Will ere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning to complete the followinLY:
Reviewer to complete the following:
Square footage of Use:
Ledas:
rr
Under Section:'
Supplementary regulations section: --
Parking formula: 1lao
Required spaces:
Y/N
Ite o be verified in the field:
Viol'ons:
Y/(NJ
If so, ist:
Prof s:
Y/
If so, ist:
Vari e:
Y/
If sot:
, is
's:
Y/N
so, List:
Clearances: n r� 1 ^r� �
SDP's
Revised 7/1/2011 Page 3 of 3
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,
[County application name and number]
was provided to carr wood products Ilc,c/omanagement services corp the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number 06100-00-00-027CO
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
JMailing a copy of the application to carr wood products Ilc,c/o management services corp
[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:
P O BOX 5306, CHARLOTTESVILLE VA, 22905
[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].
Signa re of Applicant
ASHWATI RAMCHANDRAN NAYAR
Print Applicant Name
Date
J\
11 n
kn4- O -,v ee.