Loading...
HomeMy WebLinkAboutCLE200800251 Legacy Document 2013-04-05• n • ° ,S4�FA� Application for Zoning Clearance �� m hp g OFFICE USE ONLY Zoning Clearance = $35 CLE # Z 0 ©� PLEASE REVIEW ALL 3 SHEETS Check # Date: //-ZS-O!? Receipt # Staff: i PARCEL INFORMATION Tax Map and Parcel: 0% J&t fC&P 000 C21ACExisting Zoning oar% &)er + 6 Parcel Owner: A bAwft 'o_ Parcel Address: 799 '11'W- ScAldt(L -%X- , City �4 (include suite_or floor)_____- ____ -_ - - - J]j - APPLICANT INFORMATION Who sho Address Office PI State Zip Z. Z U2 ------------------------------------------- PRIMARY CONTACT Business Name /Type: Previous Business on this site: Proposed use: State # V E -mail -------- - - - - -- - - -�----------------------- /1 r J ---------------------------------- - - - - -- Circle (if applicable): Fireworks / Christmas Tree SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet 1) *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 o �estfmyknowedg ve the ow r permission to use the space indicated on this application. I also certify that the information provided is true and accurate t . I have read the conditions approval, and understand the ,and that I will abide by them. - ----------------------- - - - - - ------ - - - - -- ------------------------------------------------------------------------------------------------- APROVAL INFORM - - ATION [ Approved as proposed-' [ ] Approved with conditions [ ] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing E. site plan. - - [ ] This site complies with the site plan as of this date. Building Official Date i t -A-.V Zoning Official ' Date fill Other Official Date ------------------------------------------------------------------------------------------------------------------------------------------------ County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 9/28/05 Page 2 of 4 4 Intake to complete the following: Applicant to complete the following: Y/N - - Do you have one of the following? e_/ � Tax Map and Parcel Number and or; Address of use (include unit or floor if appropriate; Y/N 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. , oning Tech to Violat'ons: Y / i1 If so, "List: Variance: Y / If so, st: the Y/N Is us m LI, HI or PDIP zoning? Engineer's Report (CER) packet. If so; give applicant a Certified Y N; Wi ere 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 Y /N� Is p 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 Y // N on public water and sewer? Y/N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Y/N Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Y N' Is t or sales of Fireworks? If so, obtain a copy of F/R permit. Permit # Proffers: Y /tIf so, st: SP's: Y/6. If so, List: y //6 /uJ rage j Or 4 Reviewer to complete the follow_ hw, Square footage of Uses: �(g Y / N Permitted as: Under Section: Supplementary regulations section: I a Parking formula: Required spaces: Y/N Items to be verified in the field: Inspector Name & Date: Notes j /2ts /uo rage 4 or 4