HomeMy WebLinkAboutCLE200800001 Legacy Document 2013-01-031 1
Zoning Clearance
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PLEASE REVIEW ALL 3 SHEETS
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Existing Zoning: CL
Parcel Owner: C Ci
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Parcel Address:
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� Rate 7iI�C�
9�(i�rClutW vrA or 8 flo
Contact Person .(Who should we call /write concerning this project ?):
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�xSe.� r � City l �l �,� � State Zip
Addressr D f\A-�
I C E -mail
Daytime Phnlle_
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Business Name /Type:
Previous Business on this site:
Proposed use:
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet 1)
Circle (if applicable): Fireworks / Christmas Tree
*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 ied e I have read the ondrt conditions of approapplication.
al, and I understand tthem, and that I will
information
nrnvided is true and accurate to the best of my g
Date
APPROVAL INFORMATION [ � pp A roved with conditions Baekflow Device and /or
[ ]Approved as proposed
Current Test Data Needed
[ ] Bac flow
device and /or current test data needed for this site. Contact ACSA 977 -4511, x l 19. lironiiattlt .�6tstil7si4$II13ulx 119
[ o physical site inspection has been done For this clearance. Therefore, it is not a determination o coil
[ j This e on 1' wit the , itg eplan as of th' date.
Date
Building Official Date 8
Zoning Official Date
Other Official
FOR OFFICE USE ONLY CLE
Fee Amount 3 �� �0 0 Date Paid ! -3-Li 4y who? Cv h i la.. Receipt 1E (o ��� Ck# BY
5 hCA
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) Z96 -5832 Fay.: (434) 972 -4126 5 /1 /06 Page 2 or4
Applicant to complete the following:
Do you have one of the following?
❑ YES KNO
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate)
❑ YES NO
Do you have! a loor Plan (sketch or an architectural drawing) that
includes the following, and if so please provide it with the
application?
Tile total square footage of the use and /or;
The square footage of each room or area of use;
Use of each room or area
If using less than the entire structure, note the location within the
structure.
coning Tech to c
Violations:
❑ YES ❑ NO
If so, List:
Variance:
❑ YES ❑ NO
If so, List:
the
1ntaKe Lu C0111PIMU LIM 1U11UYY111g:
❑ YES 54 NO
Is use in LI, P17or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
❑ YES S NO
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
❑ YES �Q,,NO
Is parcel on private well and septic?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from
Health Dept, FAX DATE
Q YES ❑ NO
Is on public water and sewer?
❑ YES [� NO
Will you be pu ting up a new sign of any kind? If so, obtain
proper Sign permit,
Permit #
❑ YES 4 NO
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
❑ YES NO
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
❑ YES ❑ NO
If so, List:
SP's:
❑ YES ❑ NO
If so, List:
r�
I
Square footage of Use:
❑ YES ❑ NO
Permitted as:
Under Section:
Supplementary regulations section:
Parking formula:
Required spaces:
❑ YES ❑ NO
Items to be verified in the field:
Inspector Name & Date:
Notes
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