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HomeMy WebLinkAboutCLE200800011 Legacy Document 2013-01-03i 1-X FF 11%." 1.1"11 1 V 1 Zoning Clearance t �ttflN�^ �x I S l J C1 Q � Cs5 CN PsS G�G.cte Ow�e t�(L� Zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS 06 120 Oq 06 C30 ICO ©(v t;z0 - -03 -00 -00 5 0 Co l =0 na oe CC>`fb scot zC) 0 n L-,�u vv---J ,,U Tax map and parcel: a(-z-()-n:S- 00- 6051)0 Existing Zoning: ?ra, rv�-, L, �j� r �n Parcel Owner: � i_ouv, � i_c,^,A Phbj R �.5 _ / Parcel Address: ( 3D0 �,a4&o -. Lo-vJs Zgx\r?' City ��!` �d �5�(�� State V A (include suite or floor) Contact Person (Who should we call /write concerning this project ?): l —N�� ( � l\ e �2- C p Address 10083 0-Tf,-LiTz)t3 1z(Q C C.- kw"oA,cc State ()A- Zip c�3c p Daytime Phone &1 :b'a'[ 050_04" Fax ft M6 Sat 0 665 E -mail W K1 tt e+-2 Business Name /Type:��UC— ���`� -5 Previous Business on this site: ��� e_�k L0--11cA 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 15t AAE-00 �� P a Ldp ( Y P D PS Print Name APPROVAL INFORMATION [1 ] Approved as proposed [zpproved with conditions [V Backflow device and /or current test data needed for this site. Contact ACSA 977 -4511, x119. [ ] No physical site inspection has been clone for this clearance. Therefore, it is not a determination of compliance with the existing site plan. [ ] This site coplylies with the � site^plan. of this da te:,/ Building Official _- �-�-� -� Date Zoning Official Date Other Official Date FOR OFFICE USE ONLY G CLE V 0©� '-� Fee Amount $�a,� Date Paidt— - 0 By who — Receipt 11 �SJ Ck/ S� By: W 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 ol'4 omplete the following: of the following? �'ES ❑ NO Va•c 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? 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. _Zoning Tech to c Violations: ❑ YES ❑ NO If so, List: Variance: ❑ YES ❑ N If so, List: the ❑ YES ❑ NO Is use in LI, HI or PDIP Zoning? Engineer's Report (CER) packet. If so, give applicant a Certified YES [] NO W 11 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 %., 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 [V YES F-1 NO Is on public water and sewer? ❑ YES �] NO Will you be piltting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑ YES rk NO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # ❑ YES [Z NO Is this for'sale``s of Fireworks? If so, obtain a copy of F/R permit. Permit # ❑ YES ❑ NO If so, List: SP's: ❑ YES ❑ NO If so, List: e 5 /1 /06 Pige 3 of 4 Ner to complete the following: ate footage of Use: �] YES ❑ NO V� Permitted as: Under Section: �V Supplementary regulations section: Parking formula: Required spaces: gw:� [] YES ❑ NO Items to be verified in the field: Inspector Name & Date: Notes 5 /1 /06 Page 4 of 4