HomeMy WebLinkAboutCLE201700141 Application 2017-06-16Application for Zoning Clearance
CLE 41
OFFICE MNLY
PLEASE REVIEW ALL 3 SHEETS
Check # Date: � 1
Receipt # ( 1-1-0 Staff:
PARCEL INFORMATIO 93413,O
Tax Map and Parcel: Existing Zoning J 11 '
1l; &YWi2,bC
Parcel Owner: , ;2(� (�A-
Parcel Address: //�� L-
�� L�ti �- YLvO . �y�y � State Zip
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project?
UIC
Address: •L,-6 City State Zip 2—Z�
(V
Office Phone: �,I -ell - � Fax # E-mail G l h o0, t
11
�(00
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name/Type: TJU.a A t ('Ssorl Q.S LL.C—
Previous Business on this site
Describe the proposed business including use, number of employees, number of shifts, availableparking spaces, number of
vehicles, pnd any a ditional inforrWtion that you can provide:
l'u aJ\J An
i>
*This Clearance will bnly be vale n the pa el 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 be o ovule g� I have read the conditions of approval, and I understand them, and that I will abide by them.
SignatureC Printed R%C ,q ZS 9 ti
PPROVAL INFORMATION
Q 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 I %
Zoning Official / Date _ (11w,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
;flu.
Revised 11/l/2015 Page 2 of 3
Intake to complete the following:
Y
Ise
s use LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y /
Will ore 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 we =rtment
er?
If private well, provide form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that app�i2'S"-----,
Is parcel on septic or blic sewer?
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
z,oning to complete the following:
Viol ions:
If /r
If so, ist:
Variance:
Y /
If so, st:
Clea rances:
Reviewer to complete the following:
Square footage of Use:
Y)/N
Permitted as:
Under Section: 2�•2
Supplementary regulations section:
Parking formula:
Required spaces:
Y/
Ite s to be verified in the field:
Inspector : Date:
Notes:
Revised l 1/I/2015 Page 3 of 3
Exhibit A
Tilla Accessories,
100 sf, Location 41
WOMEN'S
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MEN'S & HOME
WEB PLAN
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CHARLOTTESVILLE
FASHION SQUARE
ti CHARLOTTESVILLE FASHION SQUARE WASHINGTON
O ROAD
CHARLOTTEV00 ALER A PRIME GROUP
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