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HomeMy WebLinkAboutCLE200800015 Legacy Document 2013-01-03- Xtypll%�a Llull lux Zoning Clearance ��r F ❑ Zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS Tax map and parcel• 0O 6b "- d C` d y — I3 �76 Existing Zoning: 1T Parcel Owner: 1641M (A Id � L / Parcel Address: 702 -�l tt`� ����C �u�iP 3 City C4r_h Ps✓t'1 /C� State Zip Z-L)0- (include suite or floor) Contact Person (Who should we call /write concerning this project ?): Address 03aZ [r •LA fm ls,.J elz_ City State l/ �4 Zip ,.2 270 Daytime Phone ( I qO - 0 5700 Fax # L—) E -mail Coll Business Name /Type: ` ✓/YCC(� Previous Business on this site: '51n,411d aae S Proposed use: SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet 1) Circle (if applicable): Fireworks / Christmas Tree *This Clearance will only be valid on the parcel for which it is approved. If you change, intensify or move the use to a new location, a new Zoning Clearance will be required. I hereby certify that I own or have the owner's permission to use the space indicated on this application. I also certify that the information provided is true and accurate to the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature of Business 0 iner of Agent Date Print Name APPROVAL INFORMATION fj] "Approved as proposed [ ] Approved with conditions ] Backflow device and /or current test data needed for this site. Contact ACSA 977 -4511, x 119. ] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing site plan. ] This site complies with the site plan as of this date. Building Official Date I 3l Zoning Official Date 4 / ;/,/Og Other Official Date FOR OFFICE U_$E ONLY A' CLE # 01602006 Pee Amount / L1� Date Paid ) 6b By who? S Receipt If CH / By: V Y --xP26!�S County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 5/l/06 Page 2 of 4 ;cant to complete the following: Do you have one of the following? 2--'?ES ❑ NO Tax Map and Parcel Number and or; Address of use (include unit or floor if appropriate) P- 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; �� 17 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: 1/' YES ❑ NO If so, List: Variance: ❑ YES �Z NO If so, List: Mete the followin ❑ YES [Zf NO Is use in LI(HI or PDIP zoning? Engineer's Report (CER) packet. If so, give applicant a Certified ❑ YES N 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 [� 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 YES ❑ NO Is on public water and sewer? ® YES ❑ NO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # L) :51— / -7 7 ❑ YES 0 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 Xj NO If so, List: SP's: ❑ YES ❑/ NO If so, List: i 5/1/06 Page 3 of 4 •Ier to complete the following: (/�� re footage of Use: YES ❑ NO Permitted as: 'To �j4 6 Under Section: < I Supplementary regulations section: 2 Z' 2_ (/0 Parking formula: A 9 X ` Required spaces: rd ❑ YES ,.® NO Items to be verified in the field: Inspector Name & Date: Notes 5 /1 /06 Page 4 of 4