HomeMy WebLinkAboutCLE201700265 Application 2017-11-30Application for ZoninClearance
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CLE # gVII O(a o ,S
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PLEASE
OFFICE USE On Y l o
REVIEW ALL 3 SHEETS
Check # Date:
Receipt # / U Staff:
PARCEL INFORMATION
Tax Map and Parcel: 06 / 0 — G 1 - 6 A - U U 9,4 O Existing Zoning CJ- t;w c I A i-
Parcel Owner: C6 rK\J)1614 0 C 7t4 i2, LJ S l fife :>S C N,9 " rc L L C e( I %t
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Parcel Address: 2 3 ,o4 City VA Zip -2 all e )
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? L 65L1 C LU Val r3 E✓LC)
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Address: 23i)G CR%MMuN WL-_)9 0}1 D y2 City CHAzw7'fES\)iLLCState VA Zip7Z%-1
Office Phone: Il 'q) Zy Z' 491<:� Cell # SAYrv€" Fax # „I [A- E-mail LESLIr-LU10_rrt7&6mq- Il.
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name _New business
Business /Type. IMr.Ss rR6 C Ytg f-t A N u &SOy w 09-
Prev us Business on this site 122�i Y 2S LF I�(GN 7 ; { �nASS �1G£ AN,
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: IH1S SPcvcE7 Wt5 fit 3c, N!u4 �t�
AtiL- R l C c n+7Y '�uC `lWCSit-C- TYPE 3u S I,Ac SS fa - i2y1-iT Ya 2S" Lf 21a<N 7 .' NFL <Fr2
1X51N� 7N15 Sesvti $PACE old D�Fr�te�v7 T'PYS l,� -rar
*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 too the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature /( ,� t�^fe t e� it Printed LESL./E i_7 Lwy,-V2e-k-6
AVROVAL INFORMATION
Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] B ow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, x117.
[ o 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 i i /AL�
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 I I/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 /io
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 Ink1b c water
If private well, provide 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 septic o 'public sewer?
Y
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y (N j
Wi ere 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: --_ 12
Y/ N i` n ky) s p Permitted as: ri
Under Section: Z j ,Z.• I L 0
Supplementary regulations section:
Parking formula: `
t� c► �f � t I / � ►� r� l�� e�
Required spaces: 3
Y N
Item to be verified in the field:
Inspector :
Notes:
Date:
Violations:
Y/N
If so, List:
PrnNs:
Y
Ifst:
A W e p
ance:
VsoList:
ltlB(� _. SGi
SP'�N Y�NJ,
If so, is,
Clearances:
LLt jZk6 -18`L i"re,.} yaj/SCIf
SDP's
Revised 11/1/2015 Page 3 of 3
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PROJECT NAME:
COMWONWE4 TH BUSINESS CENTER
SURE 101
WASSAGE BY USA WOOD
DRAWN BY: CHTISTE11 FORT},tt LL R
CHARLOTTESVILLE, VA
DATE;O /whmFL SCALE: 1/A* a 1W
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340 OREENBRIER DRIVE CHARLOTTESYILLE, VIRWNIA 22901
REVISIONS:
DATE: BY: