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HomeMy WebLinkAboutCLE201800022 Application 2018-02-017 it CLE # — OFFICE Ut rLI' PLEASE REVIEW ALL 3 SLEETS Check # Date: Receipt #5 4116 Qa 2TStaff:'-- PARCEL INFORMATION �; ` 1 S92A Tax A4ap and Parcel: 0(0160 -60 -66 D Existing Zoning Parcel Owner: _4 /Vj©N /_ LC1 - Parcel Address: Z 3{�`0 City h"6tki.u�State Zip c(0 (include suite or floor) Sate. 6 PRIMARY CONTACT Who should we call/write concerning this project? G Address: S[o hosier In City Clow[yesvJ(O State V Zip Office Phone: Cell # 70-7 74-818�Fax # E-mail d'et o.C, (9 APPLICANT INFORMATION Check any that apply: Change of ownership � Change of use Change of name Newv business Business Name/Type: 0(\ Previous Business on this site M�FYhilir �c'_ ccvU� Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of vehicles, and an , additional information that you can provide: F,-i neSS �ersonul , -[ 2 p�(�=cam_ �t1 V ,c4e 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 cerlity that I own or have the owner's pen nission to use the space indicated on this application. I also certify that the information provided is true and accurate to the best of my knowledge. I have read the conditions of approval, and I understand them; and that I will abide by them. Signature ic�.��-`jay/ Printed 4y�i�„i AcrgU, AP PROYAL INFORMATION [vJ Approved as proposed [ ] Approved with conditions [ ] Denied [ ] Back w prevention device and/or current test data needed for this site. Contact ACSA; 977-451 1; x 117. [ o physical site inspection has beet) 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 �-Nr Z,oning Official �, Dale 1 Z6 113 Other Official Date County of Albemarle Department of Comnntnity Development 401 1Iclntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 Rc%i'ed 11 02 201" pane ? of , Intake to complete the following: Y & Is use in LI, HI or PDIP zoning? If so; give applicant a Certified Engineer's Report (CER) packet. Y A 011 Will there be food preparation? If so, give applicant a Health Department form. Zoning review can not begin until we receive approval fi-om Health Dept. FAX DATE Circle the one that applies --- Is parcel on private well or, ublic Nvatef? If private well, provide Health Department form. Zoning review can not begin until wve receive approval from Health Dept. FAX DATE Circle the one that applies s Is parcel on septic o>�iublic sewer? .�)/ N Will you be putting up a new sign of an km ? If so; obtain proj)er Sign pen -nit. 15 /-iw AA 14C Als f'C2.44"-I- RIZ J.cluL` Permit ## S16 A( / &D' Will there be any new construction or renovations? If so, obtain the proper Pennit. Permit #1 Zoninp, to complete the following: Violations: Y/N If so; List: Y / N Clears trees: ,l 2ols - 26() 33 2 0 3— Z.o l 140 Reviewer to complete the follo��,ing: Square footage of Use: 6 Y/N Pennitted as: A Under Section: Ly . 2. 4 Zl Supplementary regulations section: Parking formula: t Required spaces: I Y N lie e verified in the field: Inspector- : Date: Notes: Pro s: Y / N If s , Lrst: �E EEs: Y Ifs st: SDP's Peviscd I I. 1'2015 Page 3 of 3 j;co �j, fl, QLU C-< Q4 Required mechanical ventilation for proposed occupancy from the 2012 Virginia Mechanical Code PEOPLE OUTDOOR AREA OUTDOOR OCCUPANCY CLASSIFICATION OCCUPANTDENSITY AIRFLOW RATE IN AIRFLOW RATE IN EXHAUST #/1000 FT2a BREATHING ZONE BREATHING ZONE AIRFLOW RATE Rp CFMIPERSON' Ra CFM/FT28 CFM/FT28 i Health clubiweight room I 1� ?0 HIS I —