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Home My WebLink AboutCLE201500105 Application 2015-09-02Application for Zonin Clearance [ 0CLE # �, S — PLEASE REVIEW ALL 3 SHEETS OFFICE USE ON4Y Check # t-1 S`3Date: [ Receipt ft c)'qll �1 Staff- d -Z— PARCEL INFORMATION d 3 Z a O — O e- o o- od S B Tax Map and Parcel: Existing Zoning _ a L Parcel Owner:_/ f1 C A A /z J $. N e w t f 4- Parcel Address: 41 a 57 5e ml 1Vola T -R City 6L; r lIt State Zip z 2 fe (include suite or floor) PRIMARY CONTACT Who * am� /w �/// #10 should we call concerning this project? �4r% Ci�Cq/r�e fof�� State V Z Z to Zi 3aQ p Office Phone: �Vpa `ll ll#CDt/o-IZ 0Fax# '617— /z d 7 0 Wi0le le E se— GAPPLICANT APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business p Business Name/Type: _ G Sa p aw (3al I d iT u & lV C o m fg Al y a4 r� T"'"._ Previous Business on this site 15Ad(f,"M'0W' ! Describe the proposed business including use, number of employees, numbe of shifts, available par!'ng spa number of vyh isles, information that ;!24 r; and any additional you can provide: J&5& C2sal al f S-�R 1 tf* t o d 76 47&1/drn MQfe A s a .es 5o Rktn S c a we R* - r4 t L_ A rim a A W 404M *This Clearance will onlf be valid on the parcel for which it is approved. If you change, intumify or trove the use to a fiew location, a new Zoning Clearance will be required. I hereby certify that I wn or have the owner's permission to use the space indicated on this application. 1 also certify that the information provided is true and dIhavereadthe nditions ofapproval, and I understand them, and that I will abide by them. my knowl;6�W&4 M�Ihoestof Signatured !n Printed APPROVAL 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 J Zoning Official ADate 25 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 (am Intake to complete the following: 0/ N use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Yl Will re 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 ublic ter'? If private well, provide Heal ent form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applies Is parcel on septic or Nlie sewer? YIN Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # YIN 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: -j--S359 6/ N / Permitted as: G,/4" e�gZWVeAbLA Under Section: -• Supplementary regulations section: Parking formula: 4 �se,� .1-f - t a}�+'! 7� OFA Required spaces: YI Items to be verified in the field: Inspector: Date: Notes: Violations: Y/) If so, List: Proffers: Yl If so, ist: Variance: Y/ If so, ist: SI'"s: Y/ If so, List: Clearances: SDP's Revised 7/1/201.1 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, L 4 AI 1 n l_ G` I e R 2 A N L¢ // [County 4plication name and number] was provided to fp l N AA�• �� W jjthe owner of record of Tax Map [name(s) of the record owners of the parcel] and Parcel Number d 3 ZOO —00 -60-40!56 1 by delivering a copy of the application in the manner identified below: Hand delivering a copy of the application to Rl C A Art c� � s �e w if [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 [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: [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]. ,G , Maw, Signature of Applicant W11'11"#m Owlqlzej— Print Applicant Name Date .J ct SOUTH REAR WAREHOUSE W .jq 7 _a 'I I 1 p a - - /Zp- -.L�, Ak� n `ASPHALT PAVEMFNT OVERALL FLOOR PLAN Al 0 z LLI o :M L w MEQ FLOVA PLM 't-' CS`^ �- R/ �0 + SOUTH REAR WAREHOUSE W .jq 7 _a 'I I 1 p a - - /Zp- -.L�, Ak� n `ASPHALT PAVEMFNT OVERALL FLOOR PLAN Al 0 z LLI o :M L w MEQ FLOVA PLM