HomeMy WebLinkAboutCLE201500134 Application 2015-07-13 (2)Application for Zoning Clearance
CLE # 1 S 1
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PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY
Check # 01 -1 -SO . Date:
Receipt # 1 y O 3 ` ,a Staff:
PARCEL INFORMATION,er 0
Tax Map and Parcel: P6 6) Q L A Cl)ExistingZoning 54O / I1 e n to i
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Parcel Owner: W a lTC_ t -AY L 6 �C
Parcel Address: ('C(t q iCe)1?t J71 C17 1j1,e1(jj ,CityI24V ZZV . l` 9(#��.�State zip zoo
(include suite or floor)
PRIMARY CONTACT 7 ,,
Who should we call/write concerning this project? PQ c -e- W 5 I rl
Address : '762%% 7iz rrr? r15 Gree p /�4. City (,1.0 7_C- % State V/ zip ZZg3Z
Office Phone: Cell # SY0-9q'7 - rax # 6j��' E-mail
032!? 7 `
APPLICANT INFORMATION .tifQ✓/a� c e la/z t
Check any that apply: Change of owners p Change of use Chan a of name New business
Business Name/Type: WA#,r y{ J- H -eq I-1 r? T A 4_ , &,;L t'C-e •-TiA G•
Previous Business on this site
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number.of' .
vehicles, and anyadditional information that you can pr vide: t' e t't f Z 1,C,
0 off. r in X72. �n
*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 bestof my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature V1�� //��i� /� "tom `�%��� Printed 8-,'`CCf R "!'!''7'e.�.
APP OVAL 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 C.
Zoning Official A Jb Date 17
Other Official Date
County of Albemarle llepartment of Communxry Oevelopmenr
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 u n LI, III 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 blic water?
If private well, provide Healt ment form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applie
Is parcel on septic or py6lic sewer?
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit. ZMAV,/�
�/�p pry od�L&
Permit # UIk�'L/i t7t-1 `-'
Y/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
7_ r-,. .-.1,.4.. 41.n 4'nllnvrinn•
Reviewer to complete the following:
Square footage of Use: q�q
Per/
mNted as: o,I c
Under Section: 00 • p I
Supplementary'regulations section:
P`rlcing ormu a: % cm O �( a
Required spaces:
It
Item be verified in the field:
LJOR 11r:'LV -V111 ww uaV iwav VT AAA
Violations:
Y / N
If so, List:
Proff�
Y /k`
If so,kf5rSt:
Variance:
Y/N
�
If so, List: -6f-714-
lj f— - �I
SP's
Y _I.
If so, ist:
Clearances:
SDP's
Revised 7/1/2011 Page 3 of 3
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(19011 (1903) 11605) (19071 (1909) (1911)
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FOR MORE Leigh Hughes
INFORMATION Assislanl Vice President
PLEASE 134.284.4007
CONTACT jeigh.hughes@cbre Charlottesville.cont
CBRE 1 314 East Wafer Street J Charloliesvilje, VA 22902
T 434.974.7377 1 F 434,974.1909 1w,n:.chre.com/charlottcsville
c 2015 CB Richard Ellis of Virginia, hu. This inform a lion has been obtained from sources believed reliable. We have not verified C BR I Charlottesville
and make no guarantee, warranty or represenialion about it. Any projections, opinions, assumptions or estimales used are for
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only and do not represent the current or future performanceof the property. You and your advisors should conduct a
careful, independent investigation of the property to determine to your satisfaction the suitability of the property for your needs. Part of the CORE affiliate network
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CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
AdministratorDeterminations or Appeals, Sign Permits, Building Permits) if the application is not the
owner.
I certify that notice of the application, w n -c- fd -ecerc- `S S,(fTwtC c
f
fZbunty application name a d number]
was provided to z(,re plu lI a /[/ if LL C the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number V 7\ l A 0 by delivering a copy of the application in the
manner identified below:
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 l r7 W:C /3 fg 11—C 6 a /C
[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]
Oil1 2 y to the following address:
Date
pe 13.E L4 077 (address; written 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].
Signature of Applicant
Print Applicant Name
Date