HomeMy WebLinkAboutCLE201600168 Application 2016-09-19Application for Zoni*n2 Clearance n1
CLE # IW'
OFFICE Uyf+ ONLY
PLEASE REVIEW ALL 3 SHEETS Check # aqq5Date:
Receipt # St
aff•
PARCEL INFORMATION
Tax Map and Parcel: Existing Zoning }
Parcel Owner: Re-A_WIC-1 q � s S ry ian , GA, �Yu, �t ok 7_10 o-r't Q
Parcel Address: �(025 Libor Vrj ���?4 City �rc�7'�T State r i i Zip pj3Z
(include suite lor floor)
PRIMARY CONTACT r�-
Who should we call/write concerning this project? Jy-'A •_ Nion 8PIE LyIA1 ,
Address: DA City [ .1,U1•� n ��a��T State r3 Zip �()'
Office Phone: (ib '161- `-,i a4cell # �g,,.r„� - Fax # E-mail t, b W"t Ld
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name/Type: _�) p nd�- w . 611A TLP
Previous Business on this site
Describe the proposed business including use, number of employees, number of shifts, available parking s aces, number of
vehicles, and any additional information that you can provide: Ua 'j (1� r � L
---
*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 o or a owner's permission to use the space indicated on this application. I also certify that the information provided
is true and accurate rte b t f m I have read the conditions of approval, and I understand them, and that I +will abide by them.
Signature Printed � �ytc n _� Ll , C5�__
APPROVAL INTORMATION
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 - -1 C t
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 11/l/20I5 Page 2 of 3
Intake to complete the following:
Y
Is UGLI, HI or FDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
VYIN
ill there be food preparation?
If so, give applicant a Health Department form.
Zoning review can not b gin ntiI we receive approval from Health
Dept. PAX DATE
Circle the one that applies
Is parcel on private well or ipaRtment
te
If private well, provide H 1 form.
Zoning review can not begi until we receive approval from Health
Dept. FAX DATE
Circle the one that applie
Is parcel on septic or b sew
YIN
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit. •
P milt # �11�_
Y N
.11 there be any new construction or renovations?
If r obtain t e�Permit. 7
Permit #
Zoning to complete the following:
Reviewer to complete the following:
Square footage of Use: I C Z-0
YJN
permitted as:
Under Section: QI AS
Supplementary regulations section:
Parking formula: 1
1)(—D / L=... in
Required spaces:
YIN
Items to be verified in the field:
Inspector
Notes:
Date:
Violations:
YIN
If so, List:
Proffers:
YIN
If so, List:
Variance:
YIN
If so, List: /
SP's:
YIN
If so, List:
a
Clearances:
SDP's
LM
own
Revised 11/1/2015 Page 3 bf 3
m
NYId MOOD 1S�i �"u P
UA�o
L06LL VA '=Tl-W LL070VHD Vbr"'13Z0717 T�
�imavM A iI RR'I+PIIS iiEm) 00Z 3TERV ANVAR
�z. ame ..1--Z ., M1.1 01 earn 1WOIN®d 1
1
IN
COMMONWEALTH of VIRGI N.
In Cooperation with the
State Department of Health
Phone (434) 972-6219
Fax (434) 972.4310
September 1, 2016
Justin Van Der Linde
90 Oak Forest Circle
Charlottesville, VA 22901
Tlrorrras Jeffervorr Malik District
1138 Hose Hill Drive
P Q. Box 7546
Charlottesville, Virginia :2906
AI NEMARLS • (.NARI C)TTFSVILLE
PLUVANNA VV41 Y tPAWWW
URFTNE COUNTY {SYANAgt]$VILLFI
NF_:'a41 ld;_Yct:Nlhitiiiil"i;
Re: Plan Reviews for (1) The Rooftop at Smoked and (2) Smoked Kitchen and Tap, 2025 Library Avenue,
Crozet, Virginia 22932
Dear Mr, Van Der Linde,
Thank you for submitting additional information and documentation as requested in the Health
Department's Plan Review letter dated August 31, 2016. The plans submitted appear to meet substantial
compliance with the Virginia Food Regulations and as such are approved,
Completed construction work is subject to final inspection and approval by this department. A
recommendation is made to schedule several construction site visits during the construction phase of
this project to allow for department comment. You are responsible for meeting all other state and local
codes (i.e. building, zoning, fire safety, etc.).
If you have any questions or concerns, you may contact me at the following:
Email: Stephanie.Yard@vdh.virginia.gov
Office: 434-972-4318
Sincerely,
Stephanie Yard, PhD
Environmental Health Specialist
Pc: Eric Myers, REHS, Environmental Health Supervisor
Archer Campbell, REHS, District Technical Consultant