Loading...
HomeMy WebLinkAboutCLE201700264 Application 2017-11-30Application f r Zoning Clearance CLE # �� 1 ('��_aLg 0 1�RG1T;1P OFFICE U N 1' PLEASE REVIEW ALL 3 SHEETS Check # Date: Receipt #U n U I Staff: PARCEL INFORMATION Tax Map and Parcel: ©wi00-Ott- DO- oz70O Existing Zoning � 6 Parcel Owner: bore Pv,.�jc* LLf— C/o e,,c- rtiWd4.- 1" W ParcelAddress:IS Yqu ve.jl-c, 12,'aL, kA 2D;-.4 City State VA zip 0 � nclude suite or floor) PRIMARY CONTACT Who should «e call/write concerning this project? VjYS th�� L2e�eill v Address: I AL I -ow), , (,;,� City Ck C'104kj gj0'e State V Zip ZZ�d f Office Phone: Cell # y31- 9$3 75SS Fax # VN-Yj - y36-� E-mail 41 �e Se e i6e rS e APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name 4--'0" New business Business Name/Type: AA&rc*,.)k, Ark(iu, UC, Previous Business on this sitel)n0jole". of Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of ve ucle , and any additional information that you can provide: S jo ecs See'rN ( - UG1n v, dz 1 iz „ G:�ulc. 5°z.v; ce c. A/o come "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. 1 hereby cerlity that I own or have the owner's pennission to use the space indicated on this application. 1 also certify that the information provided is true and accurate to the best my knowledge. 1 have read the conditions of approval, and I understand them; and that I will abide by them. Signature C/ Printed Ui,r hid A L w-ll AP OVAL INFORMATION ' Approved as proposed [ ) Approved with conditions [ ) Denied [ ] Back w prevention device and/or current test data needed for this site. Contact ACSA, 977-4511; x 117. [ 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 A Date Other Official Date County of Alben;arle Department of Community Development 401 Mclnfire Road Charlottesville, VA 22902 Voice: (434) 2.96-5832 Fax: (434) 972-4126 Rr-viserl 11 "02 2015 Pane 2 ref 3 Intake to complete the following: Y Is us n LI; HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y N Wi] ere be food preparation? 1f so, give applicant a Health Department form. Zoning review cannot begin until we receive approval from Health Dept. FAX DATE Circle the one that applies Is parcel on private �i ell r public Ovate . If private well; provide H lent form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that 'es Is parcel on septicCo,public se er? Y / N Will you be putting up a new sign of any kind? If so, obtain proper Sign penmit. Permit # wev14 t_ tq Uly`G SCPf1r(-%Vpp r v�.t Y / N Will there be any new construction or renovations? If so; obtain the proper Permit. Permit # t�C SfPGtrinr(� �kJM,� Zoninp- to complete the followin N7- I ors: Y/N I ist: Var" e: Y N If so, Est: Clearances: ::--; Revie« er to complete the following: Square footage of Use: 10 ZG i Y 1\ ennitted as: pj�frSjIOrA' Under Section: V�, 7- Supplementary regulations section: Parking formula: fj l 1 /Too o. �efn plale-f Required spaces: O Y/N lle o be verified in the field: Inspector : Date: Notes: Pr s: Y/N Ifs , ist: ZmA 1g 73- ?$y Y N so, List: $6` 88 SDP's M Re i�cd 1 1 1 201 ` Pace 3 of 3 20 x 30 (600 ft2) Group Roam 10x5 (50ft2) Bathroom 14 x 7,5 (105 W) Office 14x 7.5 (105 ft2) Office 14 x 15 (210 ftv) Waiting Room INTERIOR HALLWAY EXTERIOR EXIT Total Square Footage: 1020 EXTERIOR EXIT 233 HYDRAULIC RIDGE RD SUITE 203-A