HomeMy WebLinkAboutCLE201700273 Application 2017-12-08Application for Zoning Clearance~°� "
CLE #
`IRGIN�P
OFFICE USE ONLY
PLEASE REVIEW ALL 3 SHEETS Check # S'�S� Date: 1 Z-S=2oi7
Receipt # - Staff;
PARCEL INFORMAT N
Tax Map and Parcel: ^ � _ Existing Zoning 14il
Parcel Owner: aE V1 A
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Parcel Address: City ' N (`� State V ZZ 8
(include suite or floor) ziV —
PRIMARY CONTACT
Who should we call/write concerning this project? Oil q�n n (p M
Address : o (4City tate
y � 1 zip 02 -
Office Phone: Im• ll # Fax # E-mail OM
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name ew business
Business Name/Type: , C— � C5 (� I Ak,� fGA I`
Previous Business on this site
Describe the proposed business including use, number of employees number of shifts, available parking spaces, number of
vehicles, and any dditioil information that you can provide: k4 (,y �(,
VA
V1 r ,� ;.
v
* is Clearance will only be valid on the p cel 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 r have the owner's permission to use the space indicated on this application. I also certify that the information provided
is true and accurate.1 the e of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed_ t/VIiV� s�A6 0AAX
IA�pproved
VA�as
INFORMATION
proposed [ ] Approved with conditions [ ] Denied
[ 1,41d7ow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, x117.
1, o [ V 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 VA -
Date jilt'' "�-1 'f
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
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the
owner.
I certify that notice of the application, NI.WyAit (a-JA!,
[County application name an umber]
was provided to V r,- the owner of record of Tax Ma
[name(s) of the recor owners of the parcel] �/ ZI /
p
and Parcel Number 7 T l- �p — 0� y
A % by delivering a copy of the application in the
manner identified below:
Hand delivering a copy of the application to ���it ` l l\
[Name of the rec d owner if the record owner is a
person; if the owner of record is an entity, identify the recipient of the record and the recipient's
title or office for that entity]
on
Date
Mailing a copy of the application to
[Name or the record owner if the record owner is a person;
if the owner of record is an entity, identify the recipient of the record and the recipient's title or
office for that entity]
on
Date
to the following address:
[address; written notice mailed to the owner at the last known address of the owner as shown on
the current real estate tax assessment books or current real estate tax assessment records satisfies
this requirement].
Signature licant
,l4 M �hn,� 0 SW�-
Print Applicant Name
Date
Zoning Clearance Checklist
Applicant MUST HAVE the following information to apply for a Zoning
Clearance:
1) Tax Map and Parcel or Address, Building Name, Suite/Unit/Floor numbers, if applicable.
2) A Floor Plan - either a sketch or an architectural drawing
a) If using less than the entire structure, note the location within the structure;
b) Note the total square footage of the use;
c) Note the square footage of each room or area of use;
d) Note the use of each room or area of use.
FEES
Zoning Clearance = $54
Temporary Fundraising Activity = No fee
Conditions of Approval
FIREWORKS:
1. No person shall sell, offer for sale, store, display or discharge any fireworks in any filling station or on any premises where
gasoline or other inflammable liquids are stored or dispensed. (Code 1967 10-13.) County Code Section 6-200 and 6-300 and must
be a minimum of 100 ft from any gas pumps/propane distribution tank.
2. The site shall be cleaned and restored to its original condition on or before July 1 lth. This shall include removal of all structures,
signs, debris, and the like.
3. A thirty (30) foot front setback shall be maintained, Display shall be located so as to avoid traffic congestion. Modifications
subject to Zoning Administrator's approval.
4. Building permits shall be obtained for all proposed structures and/or lighting.
5. Sign permits shall be obtained for all proposed signage.
6. The sale of fireworks requires a special permit from Fire/Rescue department.
CHRISTMAS TREES:
1. The outside storage of combustible material or flammable materials shall be located so as not to constitute a hazard and shall not be
less than 15 feet from any building on the site. Any open burning must comply with the Virginia Statewide Fire Prevention Code and
the Albemarle County Code.
2. The site shall be cleaned and restored to its original condition on or before January 2. This shall include the removal of all
structures, signs, debris, and the like.
3. A thirty (30) foot front setback shall be maintained, Display shall be located so as to avoid traffic congestion. Modifications
subject to Zoning Administrator's approval.
4. Building permits shall be obtained for all proposed structures and/or lighting.
5. Sign permits shall be obtained for all proposed signage.
OTHER REVIEWS:
1. Is the property on public or private water/sewer?
Private requires Health Department, Public requires ACSA review (2 to 5 days)
2. Will you be operating a bakery?
USDA review is required (approx. 2 weeks but as long as 6 weeks)
3. If you are serving prepackaged baked goods but not making them on the Premises, only Health Department will review. (2 to 5
days)
4. If you will be operating any business that is in an industrially zoned district or of an industrial nature you will need to provide a
Letter of Performance Standards or Certified Engineer's Report (a staff member will provide an information packet addressing this
requirement) (5 to 10 days as soon as the Letter or Report is received by this Department)
5. If there has been no site inspection within the last three (3) months for the parcel/site, then one will be conducted to verify that the
project is in compliance with an approved site plan (if applicable).
Revised 11/1/2015 Page 1 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 / O
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 public water?
If private well, provide Health Department for .
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applies
Is parcel on septic or public sewer?
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit. Permit # N OVI d leg ►/ e�, A sz�4 + �� F �f t r1AL
Y/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit# 'e d►(t? Et Sefc�rc�e, QCIM
Zoning to complete the following:
Reviewer to complete the following:
footage of Use: S v o 1 T'L
Y�//N
ralfitted as: 4 Y) of oI C V C,
Under Section: 2� �_ QJ
Supplementary regulations section:
Parking formula: , 1f lI P►�al�yPe
Required spaces:
Y/N
It be verified in the field:
Inspector : Date:
Notes:
Vi ns:
Y/N
If s List:
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Clearances:
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Revised 11/1/2015 Page 3 of 3