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HomeMy WebLinkAboutCLE201700128 Application 2017-06-137 Application for Zoning Clearance : w CLE # )lg- IAR___- ., PLEASE REVIEW ALL 3 SHEETS OFFICE USE ONLY - Check # _ Date: Receipt # Staff: PARCEL INFORMATION Tax Map and Parcel: Existing Zoning PC -MC Parcel Owner:51h Street Station Ventures, LLC Parcel Address:355 Merchant Walk Square City Charlottesville State VA Zip 22902 (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? Dan Tucker Address: 5 SW Broad Street Suite B _ City Fairburn State GA Zip 30213 Office Phone: (770) 692-8300 Cell # 404-245-4909 Fax # 770-692-8302 E-mail dan@sjcollinsent.eom QA.�i /a•vJ• �YwAr S � � G APPLICANT INFORMATION Alamo Draft House Check any that apply: Change of ownership Change of use Change of name X New business a Business Name/Type: Alamo Draft House Previous Business on this site undeveloped aces, number of Describe the proposed business Including use, number of employees, numb r of shifts, available Wa4 vehicles, and any additional information that ou can provide: !!�W�C t`lL / 33, �� s• 70 �� 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 new location. a new 7.0ning Clearance will be required. hereby certify that I own or have the owner's permission to use the space indicated on this applicntion. I also certify that the inforrnatlon provided is true and amurdle to e b rol fowled, 1 have read the conditions of approval. and I understand them, and that I will abide by them. Signature Printed goes,441� �¢ � APPROVAL INFORMATION �J 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 or 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 //�� 2,►7:Z Other Official 140 Date County of Albemarle Department or Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126 Revised 11/02/2015 Page 2 of 3 Intake to complete the following: Y /O Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. DI 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 u lic water. If private well, provide Health epar ment 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 ublic sewer. / N Will you be putting up a new sign of any kind? If so, obtain proper Sign per 't. Permit # l 1 ©/ N Will there be any new construction or renovations? If so, obt t e rop rmit. Permit # - RC Zoning to comDlete the followine: Reviewer to complete the following: Square footage of Use: 33,765 (9/ N Q Permitted as: TyrJ�v,� ��✓�'i. e��L�sd"1w 1 Under Section: `)- S. i Supplementary regulations section: Parking formula: Required spaces: / 0 Y /O Items to be verified in the field: Inspector: Notes: Date: Violations: Y /e If so, List: Proffers: (�/ N so, List: Var nce: Y / If so, List: SP's Y /k) If so, List: Clearances: SDP's Revised 11/1/2015 Page 3 of 3