HomeMy WebLinkAboutCLE200800085 Legacy Document 2013-01-11Application for
Zoning Clearance
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County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
511106 Page 2 of 3
OFFICE USE OILY
❑ Zoning Clearance = $35
CLE # 9• b6 666 o
Check # III? Date:
PLEASE REVIEW ALL 3 SHEETS
Receipt # %O 3 Staff: VTR
PARCEL INFORMATION
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Tax Map and Parcel: 6 ` � y V ^ 6 3-06 "� �'j � � Existing Zoning )-46
Parcel Owner: f �o \Y Q- L,=) U-3Cx z �S
Parcel Address:_; 0OL4 0 _r (L-vrn C, r Q r City S. State V f� Zip o� ®
(include suite or floor)
PRIMARY CONTACT
JC?
Intake to complete the following:
❑ 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
Dept. FAX DATE
❑ YES ❑ NO
Is parcel on private well o puOiil c water?
If private well, provide H Department form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
❑ YES ❑ NO
Is parcel on septic o public s
❑ YES ❑ NO
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 #
GOmn2 l ecia to COMMete the IonowlnQ:
Violations:
❑ YES Z NO
If so, List:
Variance:
❑ YES JNO
If so, List:
Reviewer to complete the following:
Squar footage of Use: ;00 ;YES ❑ NO
Permitted as: J i aj
Under Section. ZL! • J.(
Supplementary regulations section:
Parking formula)
0V •
Required spaces:
❑ YES VNO
Items to be verified in the field:
Inspector : Date:
Notes:
Proffers:
❑ YES
If so, List:
[?NO
SP's:
❑ YES
If so, List:
. NO
5/1/06 Page 3 of 3