HomeMy WebLinkAboutCLE200800002 Legacy Document 2013-01-03Tax map and parcel:
t- Xppll1,QLlVll 1V1
Zoning Clearance
❑ Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
mil/ o _01-614 _VU 5V D
Existing Zoning: C
Parcel Owner: ��2C'f�.VlfrC+f )r. (,k(- a vfgi fttct UM(, -W le(A('i' y coMpan
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Parcel Address: 3 -go 6(i� h �ffTo �. City1�y�(�� State Zip
(include suite or floor)
Contact Person (Who should we call /write concerning this project ?): t� 0 CIr/1 .� - Voer-
Address -6S ` lNe 6{ oue C - City ��C} �/ State V`.� Zip
Daytime Phone CPA a�5 d Fax # U
E -mail
Business Name /Type: W Uu4z4 6; prose r (% � +O (-
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Previous Business on this site: e)(((CA01 ���--E= �Gl C t �e ` - 'TO' f'O��
Proposed use: �� c-0 SC' S �1 ` (L-
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 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
abidAbv them.
or
Print Name
- 3 °09-
Date
APeROVAL INFORMATION
[PJj Approved as proposed [ j Approved with conditions Backflow Device and /or
,�,B� ckflow device and /or current test data needed for this site. Contact ACSA 977 - 4511, x 119. Current Test Data Needed
[ go physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance i i i �Sc�s $7,,T-451 1, X 119
[ ) This site complies with the site plan as of this date.
Building Official Date I o
Zoning Official Date $
Other Official Date
FOR OFFICE USE ONLY j CLE Y COO— *;t, (� j
Fee Amount Date Paid 1 By who? -) It J__ Receipt /I �a I Cki/ l:� By:
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22.902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 5/1/06 Page 2 of
Arj,plicant to complete the following:
Do you have one of the following?
❑ YES VNO
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate)
XYES ❑ NO
Do you have a Floor Plan (sketch or an architectural drawing) that
includes the following, and if so please provide it with the
application?
The 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.
Tech to
Violations:
❑ YES NO
If so, List:
Variance:
❑ YES NO
If so, List:
the
❑ YES NO
Is use in L31,I or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
❑ YES gNO
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 N0
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
p YES ❑ NO
Is on public water and sewer?
❑ YES K-N0
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
❑ YES ( NO
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
❑ YES ANO
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
❑ YES El-'NO,
If so, List:
SP's:
❑ YES OINO
If so, List:
5/1/06 Page 3 of 4
,i ,1
Reviewer to complete the followqwing:
Square footage of Use:
�ES❑
NO
Permitted as:
Under Section:
Supplementary regulations section: f1 9�
Parking formula:
Required spaces:
❑ YES ❑ NO
Items to be verified in the field:
Inspector Name & Date:
Notes
5/1/06 Page 4 of 4