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HomeMy WebLinkAboutCLE201700013 Application 2017-01-20Application for Zoning Clearance; CLE #�) OFFICE USE ONLY PLEASE REVIEW ALL 3 SHEETS Check # Bcj-(,' ► Date: I) is) -4 Receipt# 1Q-J-�, _ Staff: PARCEL INFORMATION Tax Map and Parcel: 0 L [ 'Z !✓ Existing Zoning---( <;,., r t ✓ , ,, Parcel Owner: Parcel Address:! Q S i�V i, City State L/ f4- Zip L L 9Q (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? 1 e, , Address: J U f � ti,y ��a: i' K vG .�i —City G �c 1 i S IE State it Zip Z Office Phone: l j) `/S") - 0 03 `f Cell # Y 3 `► _ 12a6._., Fax # E-mail i^ ` c 1 ' i1 APPLICANT INFORMATION _ Check any that apply: Change of ownership Change of use Change of name New business Business Name/Type: \% N v^ c; , , C L C ( C? Lh -C < Previous Business on this site Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of vehicles, and any additional information that you can provide: C C L ci,no 7�`J�,c h �� V r ;n� Uc q ,^ Y1 c *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 best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature f Printed PI c kc%(r PROVAL INFORMATION JA Approved as proposed [ J Approved with conditions [ ] Denied [ J 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. [ J This site complies with the site plan as of this date. Notes: Building Official Date Zoning Official Date 7- 7 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 /1/2015 Page 2 of 3 Intake to complete the following: Y/N Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. YIN Will there 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 p lic wa ? If private well, provide Health artment form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that ap Is parcel on septic or ublic sewer? Y/N Will you be putting up a new sign of any kind? Sign permit. Permit # If so, obtain proper I Y/N 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: I , ^ ) ` 1 rY/N Permitted as: ► C Under Section: Supplementary regulations section: Parking formula: Required spaces: Y/vlJ Items to be verified in the field: Inspector• Notes: Date: Violations: Y If so, List: PrOff s: YIN If so, ist: Vari e: Y/W If so, List: N If so, List: q Clearances: SDP's QUr — '7 Revised 11/t/2015 Page 3 of 3 'Virginia CLE® VIRGINIA CONTINUING LEGAL EDUCATION`"' CLE Committee January 17, 2017 Chairman: David P. Bobzien Fairfax Executive Director: County of Albemarle Department of Community Development Raymond M. White Charlottesville C/O Stewart Wright (Zoning Clearance Application) CLE Committee 401 McIntire Road Members: Charlottesville, Virginia 22902 Richard D. Balnave University of Virginia Irving M. Blank Dear Mr. Wright: Richmond James P. Cox, III Charlottesville Massie P. Cooper Richmond Jeannie P. Dahnk Fredericksburg Dana M. Fallon George Mason University Karen A. Gould Richmond Nicole J. Harrell Norfolk Jean K. Kelleher Alexandria David S. Mercer Alexandria Steven R. Minor Bristol Thomas P. Murphy McLean Douglas M. Nabhan Richmond Caroline L. Osborne Washington & Lee University Farnaz F. Thompson Charlottesville Michael P. Tittermary Ashland Lucia Anna (Pia) Trigiani Alexandria Henry N. Ware, Jr. Richmond Thank you for speaking with me by phone and for your assistance with our sign change at Virginia CLE, 105 Whitewood Road. I have enclosed the Application for Zoning Clearance and a check for $54.00. Please let me know if you need anything else from Virginia CLE regarding this action. Sincerely, Rich leglio 105 Whitewood Road, Charlottesville; VA 22901 Phone: (434) 979-5644 / Fax: (434) 979-3147 Email: vacle@vacle.org / Web: www.vacle.org Facebook: www.ficebook.coin// VirginiaCLE