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HomeMy WebLinkAboutCLE200800055 Legacy Document 2013-01-11Application for Zoning Clearance a U 7 ✓ i To ✓ f •Z.L ❑ Zoning Clearance = $35 O g 2 4 16 PLEASE REVIEW ALL 3 SHEETS Tax map and parcel: , Id 26"66 '- 00 "- 60 "— d 11 � r Existing Zoning: Parcel Owner: ( ) V A & vn ' ire 41 J Parcel Address: S�6r) 9,0,(J\ e• Wa_,/4 N' _ _ City State Va, Zip 22 C7 C23 (include suite or floor) r Contact Person (Who should we call /write concerning this project ?): ❑^GLv1Rf!S 5��, /t V. /_� <V Address S-60 &s4 (I lluyl'f• 0 City C: \c,, JA' u IIt State V6, Zip 2ZIO3 Daytime Phone `c 3y l GS1 ^�`I 3 Fax # d3� GSI'`{3GI E-mail �a�d ✓`cic ®� Business Name /Type: Ca—A :2 S\ S fit, 4 Previous Business on this site: 4--J-- A 4 I\ Proposed use: 'c- C'_cC� 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. nature of Business 0 er or Agent Date Print Name . J APPROVAL INFORMATION ;Approved as proposed [ ] Approved with conditions ] Backflow device and /or current test data needed for this site. Contact ACSA 977 - 4511, x119. ] 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 �� ��o Zoning Official Date Other Official Date FOR OFFICE USE ONLY CLE # �� bg ©6iS5S Fee Amount $ 5.0d Date Paid 542 -62 By who? G Y Ck# 6-5 By: U_T3 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 of 4 . rl,� 1000 eApplicant to complete the following: Do you have one of the following? YES ❑ NO Tax Map and Parcel Number and or; Address of use (include unit or floor if appropriate) [-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 to atho within the structure. , oning Tech to co Violations: ❑ YES pN 0 If so, List: Variance: ❑ YES 1, NO If so; List: the 1nIaKC LU 1:U111131G1C LIM 1V11UVV111J-,. ❑ YES [9 NO Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. ❑ YES 0 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 0 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 2(YES ❑ NO Is on public water and sewer? i ❑ YES (/❑ NO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Per # YES ❑ NO Will there be any new construction or renovations? 0(v� If so, obtai t - e�p�ropler,P�n't� j 1 Permit # _, ❑ YES Is this for sales of Fireworks? If so, obtain a copy of F/R permit. Permit # 1 l V'11Ma u. .r7l YES ❑ NO If so, List: -- o�a- a L, i LA-ex- 2 YES E]� O I�so�Li t� f� 5/1/06 Page 3 of Reviewer to complete the following: 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 5/1/06 Page 4 of 4