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HomeMy WebLinkAboutCLE201700086 Application 2017-04-0601 Application for Zoning Clearance"f CLE # y_ ( 21 - O UQ C PLEASE REVIEW ALL 3 SHEETS OFFICE US ONLY Check # O Y Y Date: Receipt # -Vol © 2, Staff: v PARCEL INFORM,Tl N G, � 6 � g Tax Map and Parcel: "Qr� -�7U ExistingZoning !/ Parcel Owner: rTtl q- iYl i' kxs kJ -a sip Y-t�, U sk- Parcel Address: 53 7 U lh(QQ, t,�g6)'A O City x OLaA- State \JX Zip22,.cj (include suite or floor) ! PRIMARY CONTACT v 4 Mai Who should we call/write concerning this project? Address : City State Zip allA Office Phone: ell #t�d�# E-mail -� 117 AYFL11LA1N I IN V URNIA 40 N J Check any that apply: _Change of ownership Change of use Change of name New business Business Name/Type: L� u o k-k6k Y-A s Q 77% 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: e,@, `SV 1 yko N Y S C t *This Clearance will only be valid on the parcel for which it is approved. If you change, intensify or move the use to a Aew location, a new Zoning Clearance will be required. Z 0 U S --- I I hereby certify that I own or have the owner's pe>fnission 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 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$ Zoning Official Date r� Other Official Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 z 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. Y /0 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 o public water? If private well, provide Healt e 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 o public sewer? Y N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # YAD 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: ;--b L-) YO/N pp Permitted as: Under Section: ,2 Supplementary regulations section Parking formula: Required spaces: 2� Y / Items to be verified in the field: Inspector : Date: Notes: Vi ions: Y/N If so, ist:ITso, Proffers: List: Varia ce: Y /V If so, List: SP's:. Y /'OI if so, List: Clearances: SDP's q `79 Revised 11/1/2015 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. 1 certify that notice of the application, [County application name and number] was provided to \ C\W `' - 2 J e FF - the owner of record of Tax Map [name(s) of the record owners of the parcel] and Parcel Number - manner identified below: by delivering a copy of the application in the 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 [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]. Signat' of Applicant I a Print Appl cant Name 3. 3i- 17 Date Gommunity Development Department Albemarle County 401 McIntire Road Charlottesville,VA22902-4596 Voice : (434) 295-5832 Fax : (434) 972-4126 Planning Application PARCEL OWNER INFORMATION TIVIPF 056A3-00-00-00900 Owner(s): NOTCH'D LLC Application # CLE201 700086 PROPERTY INFORMATION Legal Description ACREAGE r Magisterial Dist, ,White Hall Land Use Primary Residential - Single-family (incl modular homes -- - — Current AFD !Not in A/F District Current Zoning Primary Planned Development Shopping Center APPLICATION INFORMATION Street Address 5370 THREE NOTCH'D RD CROZET, 22932 Entered By ___ ____ ___ _____.__.__ . _ --- Buck smith E Application Type IZoning Clearance 3 __ — -_h3i72o1i Project HOLISTIC TOUCH Received Date 03/31/17 Received Date Final Submittal Date 03/31/17 Total Fees 54 Closing File Date i Submittal Date Final Total Paid 54 Revision Number Comments FHOLISTICTOUCtH MASSAGE THERAPY Legal Ad SUB APPLICATION(s) TvDe Sub Applicatio Comment u A APPLICANT / CONTACT INFORMATION ContactType Narne Address aityState Zip Phone PhoneCell O•wr rt' pr+.-sri NOTCH'D LLC 9.0 STOCKTON RIDGE PL GREENWOOD VA 22943 ... .... .... ............ .............. ..... ...........:.......................................:... ...;............... ........... . .............. .. Primary C_rtaz <DALLAIR, SOPHIA. 4342277917 ..... ....... .............. ..... ........... _ .__ ...... ... ... _........... . __............. .......:.. . ................ . Signature of Contractor or Authorized Agent Date