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Home My WebLink AboutCLE201800030 Application 2018-02-16APPROVED akn County Application for ion'i nk'Clearance CLE #L I�AGIC11p PLEASE REVIEW ALL 3 SHEETS OFFICE USY, ONLY Check # (,U Date: .1 Receipt #°W(,� S13 � S Staff: TL PARCEL INFORMATION Tax Map and Parcel: 5(p —O0 -60 -J /nno Existing ZoninglM Q ! ParcelOwner• re.� S- ,� S t� � su l 1 / d-� Parcel Address: of s7�. City vi�l= State Zip�%0,j (include suite or floor) PRIMARY CONTACT , , rho`( Who 5 should we call/write concerning this project? t1'1 porn vt� �vt1i d► c Address: 9.5 SQ►MYIa.C. City &—Vi e, State VA Zip 22%1 =} Office Phone: -64 1$+- Rqq$ Cell # rb04 " b15 `�OFax # E-mail Lovf 2 eta �AI1 @ Jw.. t .(oil APPLICANT INFORMATION Check any that apply: V Change of ownership Change of use Change of name New business � RCS I . 2- LW (, Business Name/Type: n 1'��' , + �` yj; -.�,� � C/ -ry ° .f pQ�� , L Previous Business on this site k L V 91 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: *Thus 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 he conditions of approval, and I understand them, and that I will abide by them. 27�7� Signature Printed N APPROVAL INFORMATION [ ] Approved as proposed [ ] Approved with conditions [ ] Denied [ ] Back low prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, xl 17. [ ] 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 complies with the site plan as of this date. Notes: Building Official L-� el . Date 3 / Zoning OfficialDate 2i 3 l ! t I Other Official i ryl t 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/0 Is use in LI, HI or PDIP zoning? Engineer's Report (CER) packet. If so, give applicant a Certified N ill 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 public wati If private well, provide H nt form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one p e Is parcel on sept c or public sewer. Y) N milt you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit# A-7- 8-a43Zi? Y/N Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # ZoninL to complete the following: Reviewer to complete the following: Square footage of Use: 24 UV Y/N -} Permitted as:-(01Ag&Mls6eh I Under Section: 14. 2. 1 Supplementary regulations section: c;11 U1 Parking formula: c Required spaces: ceklir" Ofr elfin It ,,,,, Ite to be verified in the field: Inspector • Date: Notes: qru, CIF 0'�Vr+r YlUYY' onl Violations: Y/N If so, List: Pr rs: Y N If so, ist: a ance: �N Ifa List: 's: Y/N s o List: -28 of n Clearances: SDP's Revised 11/l/2015 Page 3 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, was provided to [County application name and number] [name(s) of the record owners of the parcel] and Parcel Number manner identified below: the owner of record of Tax Map by delivering a copy of the application in the Hand delivering a copy of the application to 11 u Z 1 ' (! C L ame of the rerd 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 0 Mailing a copy of the application to [Name of 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]. ve 12�9e �-vtsi �C 6--rownd Ge�--_- Signature of Applicant Print Applicant Name Date COMMONWEALTH OF VIRGINIA VIRGINIA DEPARTMENT OF HEALTH In accordance with the regulations of the Board of Health of the Commonwealth of Virginia this certifies that Love 2 Eat Thai, LLC is hereby granted a permit4icense by the Albemarle County Health Department to operate a Full Service Restaurant Trading as: LOVE 2EAT Located at: 540 Radford Lane Suite 700 Charlottesville, VA, 22903 Mailing Address: 540Radford Lane, Ste 700 Charlottesville, VA, 22903 Conditions of Permit (if applicable); Date of Expiration February 28, 2019 y Environmental Health THIS PERMIT IS NOT TRANSFERABLE FROM ONE INDIVIDUAL OR LOCATION TO ANOTHER New owners are required to make written application for a permit. Please Direct Questions or Concerns to the Albemarle County Health Department Environmental Health Services 1138 Rose Hill Drive Charlottesville VA 22903 (434) 972.6219