HomeMy WebLinkAboutCLE201300204 Application 2016-07-18Application forZon'n Clearance
CLE# d15' ,
OFFICE Us O
PLEASE REVIEW ALL 3 SHEETS Check # J✓ Date: Ct 13
Receipt # Staff:
PARCEL INFORMTr� /] . .
Tax Map and Parcel: D L - A ~ Existing Zonin r
Parcel Owner: �" "�
Parcel Address: u g 9e�lb"de f{�j City iy�W ILy*-S`11e, State Zip'
(include suite or floor)
PRIMARY CONTACT �qC1 au
Who should we call/write concerning this project?
Address: 01 ciit e State zip ZzRaN
Offlee Phone: ?g 3-$� � Cell #MA-53)46Rx #4�a _ E-mail \0` ...L0 1 Q
APPLICANT INFORMATION
Check any that appl : Chanre of ownership Change of use Change of name Now business
Busineds Name/Type: +
L��
t
Previous Business on this site„ Z9 8 wt-O
Describe the proposed business including use, number of emplo = number ofshifts, available parking spaces, number of
vehlcles�and any additional information that you can � jdee:
'rPat
"'this Cieerance will only be valid on the parcel fbr 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 card 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, an(Aat I will abide by them.
Signature Printed S a k Q
APPIZOVAL 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 complianderwith the existing
site plan.
[ ] This site complies with.the site plan as of this date.
Notes:
Building Official Date 4
Zoning Official Date
Other Official Date
r .---- n__..-s... e..♦ ..r f,-...n...nniiv n0VPtf►nTn pint
40 re Ro d C Ile, VA 2902 Voice: (434) 296-5832 Fax: (434) 972-4126
j r L Revised 7/1/2011 Page 2 of 3 20
c�4'10sv. j -
Intake to complete the following:
Y
Is OLI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet,
Y N
Me 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 �ubllcwater?If privatewell, provide Heform.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that appli
Is parcel on septic public sewee'1
YIN
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permi
Permit #
Yl
Wilbe 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: Zsb[7
YIN
Permitted as: A oti,
Under Section:
Supplementary regulations section:
Parking formula:
Required spaces:
Y IINJ
Item to be verified in the field:
Inspector:
Notes:
Date:
Violations: Proffers:
(�/N Y1
If so, List If s , ist;
-644-1
Variance: �e
Oso, List fso, List:
-eel —70 ST
Clearances: SDP's
Revised 7/1/2011 Page 3 of 3
MVDB 19 0710112015
Msl.r liOfeM o.rlYrleMr
=i== saaMr tot
Wwffd.+ix9W =2a
Wnw m lb WxWi:9W
ZONING COMPLIANCE CERTIFICATION
Purpose: Use this form to certify that proper zoning is in effect for your business location and the dealer license for which
you are applying. Section 46.2-1510 of the Code of states in part, "No license shall be issued to any motor vehicle dealer unless
he has an established place of business, owned or leased by him where a substantial portion of the sales activity of the
business is routinely conducted and which: (1) Satisfies all local zoning regulations."
Instructions: Applicants complete the business information section and check each dealer license type for which your are
applying. Request the Zoning Official to complete and sign the zoning compliance certification . The zoning certification must
be completed and signed within the 30 days before dealership opening. Submit this form to MVDB.
BUSINESS INFORMATION
Full Name Ls:t First WWdle Sift (Jr., Sr., 9
Altallal Salam Jassem
umnass NWM
TradeAsName
Salam LLC
Salam LLC
Business sliest Addreae CRY or cour ly zip code
1189 Seminole Trail Charlottesville 22901
Primary Contact Telephone Number
Dale of Applicalion (mmlddnyyM
434-531-1186
7/18/2016
Dealer License Type and Zoning Compliance (check all that apply)
Instructions for Zoning Officials: The section below is to be completed and signed by the Zoning Official verifying the applicant
has complied with all zoning requirements from the City or County in which the dealership is located and properly zoned for the sale
and display of all applicable dealer license types checked below.
Zoning Official Signature
Automobile/Truck
Official Signature
❑Zoning
Motorcycle
Official Signature
❑Zoning
Recreational Vehicle
Official Signature
❑Zoning
Trailer
Special Conditions/Comments (To he compk*d by zonr a Ofrciai;rar pneenm)
Zoning Official Certification
I certify that the above named business is in compliance with the zoning ordinance of this locality for each use for which the
applicant is applying (checked above and signed by me).
Zoning Olfidal Name ON)
Zoning ORdal Name (title)
Francis H MacCall
Principal Planner
Zoning nature
Dato (mmlddlyyyy)
7/18/2016
m
r, A NNI� w
Lr) i9
z
��m W�3
0 A o ki
co via
o
�+0 ° 4)
U) A � .�
W �
w N O Ix O E- 'a w
a W 0
zNE 09
CD a W Cd
N a�w
a z
M E+ E+
O rw �aa Ln "
I/ a ''i W
a x w a E
�iE in
Q O ytaa O� WE
axon a
V N o �� wUcn �A
FEU ca 1-4
.. �OC� za
P4 43 Q L)
W AU
W E�•a W F w,
�UWZ"j
_ W a aa0�
..
a� EE