HomeMy WebLinkAboutCLE200800007 Legacy Document 2013-01-03' t 1- 11J1J111.Q1.1V11 �V1 UT Zoning Clearance
❑ Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
Tax map and parcel: ®`(56, o — 6,a — on "' d O yy Existing Zoning: j'irG
A , 1 1. , , 1.
Parcel Owner: I 1 III U11.'t'U J
I�SII �,�1r L� y Ehrbkv' I� Parcel Address: ` State Zi
(include suite or floor)
d
Contact Person (Who should we call /write concerning this project?): hri's Q_s
Address I(l (l � &nn& lh � . &k ico City CJ)jj,rjr4k�jV1 ILj State V_ Zip �qo 1
Daytime Phone `'1 1�' � `I' Fax # ��-� E -mail l yos@ aLa rko�i'�2�
Business Nam
Previous Bush
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 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 of Business Owner or Agent Date
Print Name
TROVAL INFORMATION
Approved as proposed [ ] Approved with conditions
] Backflow device and /or current test data needed for this site. Contact ACSA 977 -4511, xl 19.
] 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.
Building Official Date i % b
Zoning Official Date �-
Other Official Date
FOR OFFICE � U�SE�O.,NLY CLE 9 V bbg G�6bo I n� � ►-
Pee Amount s Date Paid w� By who? 14ka- Receipt I! D Ck11 � By: ( j :5
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 5/1/06 Page 2 oi'4
Applicant to complete the following:
Z'E'ave one of the following?
S ❑ NO
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate)
C, YES ❑ 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
the
Violations:
(A YES ❑ NO
If so, List: 11
0-7- OS '444.
/�22
Variance:
❑ YES O NO
If so, List:
❑ YES [�NO
Is use in LI, HI or PDIP Zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
❑ YES �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 DeptV7�0
FAX DATE
❑ YES
Is parcel on private well and septic?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval fi-om
Health Dept, FAX DATE
YYES ❑ NO
Is on public water and sewer?
❑ YES 5j/<O
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permi
7#
YES ❑ NO �^
Will there be any new construction r renovations? �jQ\�\ 0�
If so, obtain the proper Permit. 1
Permit # A L
El 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 7 NO
If so, List:
5/1/06 Page 3 of'4
Reviewer to complete the following: Z/ � y(?
Square footage of Use:
❑ YES ❑ NO
Permitted as: i< rrb. -�S opp+ LZ
Under Section:
Supplementary regulations section:
Parking formula:
Required spaces:
❑ YES 4 NO
Items to b verified in the field:
Inspector Name & Date:
Notes
5/1/06 Page 4 or