HomeMy WebLinkAboutCLE201700159 Application 2017-07-31Application for Zoning Clearance
CLE # __Z- J, y n .
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OFFICE USE V
PLEASE REVIEW ALL 3 SHEETS
Check# U Date:
Receipt # Staff..
PARCEL INFORMATION ION ir� � �, _
Tax Map and Parcel: "[ (� �
� � Existin Zonin
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Parcel Owner: Foxfield Racing Association
Parcel Address: 2215 Foxfield Track City Charlottesville State VA Zip 22901
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? Audrey or Cynthia Lorenzoni, Co -Race Directors
Address: 3 Elliewood Ave City Charlottesville State VA Zip 22903
d.�drey�119511,a„oavNt-a.,n'ron'Mi ,
Office Phone: (434) 293-3367 Cell# 434-962-2340 Fax# 434-293-6115 E-mail clorenzoni@embarclmail.com c"
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name/Type: Charlottesville Women's Four Miler - September 2, 2017
Previous Business on this site for the past 34 years, this 4 mile road race has been at Foxfield and on Garth Road
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:
*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 st my owledge. I have read the conditions of approval, and II understand therm, and that I will abide by them.
Signature t Printed L 01 L_(71e4A z o
APP VAL INFO TION
[ pproved 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 compl' wit the si a plan as of this dater
Notes: ti"
Building Official A Date
Zoning Official Date
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 11/02/2015 Page 2 of 3
Intake to complete the following:
Y/N
Is use in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
1 N
dill 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
Reviewer to complete the following:
Square footage of Use:
Y N �n
rmitted as:
Under Section:
Supplementary regulations section:
Circle the one that applies Sh eYn4ndZah `'� it�d
pp do�f,uJ�Do Parking formula:r,
Is parcel on private well or public water?
If private well, provide Health Department form.
Zoning review can not begin until we receive approval from Health Required spaces:
Dept. FAX DATE
ov�sh n a.— Y / N
Circle the one that applies I''C� -� t� Ite o be verified in the field:
Is parcel on septic or public sewer?
Y/0
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit # Inspector Date:
Y /r Notes:
Will ere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
J
Zoning to complete the following:
Violations:
Y/N
If so, List:
Proffers:
Y/N
If so, List:
Variance:
Y/N
If so, List:
N
00, List:
Clearances:
SDP's
- _ l Revised 11/1/2015 Page 3 of