HomeMy WebLinkAboutCLE201300098 Legacy Document 2013-05-20Application for Zoning Clearance
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CLE # U(3 - '.fit
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PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY
Check# - b Date:
Receipt # S c Staff:
PARCEL INFORMATION
Tax Map and Parcel: „019 6o - W- 60 -,0 1 -1 06 Existing Zoning
Parcel Owner: W0,3 CQ 0-r L't t-- (YV, c •% r. ,8 ( .l
Parcel Address: i, o C-+- ,- city [A,: ,ri tL, State U 6 Zip 2�2—'� `' L
- (include suite or floor)
PRIMARY CONTACT
Who should we calltwrite concerning this project?
Address: Ct �, La c rv+ lbw 1 t f 7-J City State U C- Zip Z zsjt y
Office Phone: ig3q) C1 T'7.3 41 t Cell # °f �- - S"1 Zr. Fax ,# E-mail r rz S 1n tz- '} � �
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name/Type: C'E/I G � z1 ^ S — L; n &i- re 0J'i' -f J
Previous Business on this site
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
vehicles, and any additional. information that you can provide:
*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, anew Zoning
Clearance will be required
I hereby certify that I own rbave the owner's permission to use the space indicated on this application. I also certify that the information provided
is true and accurate to th of my =ledge. I have read the conditions ofappmval, and I understand them~, and that .1 will abide by them.
Signature Printed '4 / (P
APPROVAL INFORMATION
Approved as proposed [ j Approved with conditions [ ] Denied
[) Bacicilowprevention device and/or current test data needed.for this site. Contact ACSA,. 977-4511, x117.
[ ]No o physical site inspection has been done for this clearance. Therefore, .it is not a determination of compliance with the existing
site plan.
[ J This site complies with the site plan as oftbis date,
Notes;
Building Official Date ( t
Zoning Official Date
Other a L-6 --tom Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesvllle, NIA. 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 7/1 /2471 Page 2 of
V
Intake to complete the following:
Re- viewer to complete the following: `
Y C
Square footage of Use:
Is e�' � LI, Hl or PDIP zoning? Ifso, give applicant a Certified
N
Engineer's Report (CER) packet.
pp
Permitted as: f�PC,/
t
Y
Will t re be food preparation?
r
Under Section:
if so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from Health
Supplementary regulations section:
Dept. FAX DATE
Circle the one that applies
Parking formula:
Is parcel on private well or u tie wa r?
If private well, provide He artment form.
Zoning review can not begin until we receive approval from Health
Required spaces:
Dept. FAX DATE
Circle the one that applies
item o be verified in the field:
Is parcel on septic or p er
YIN
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Inspector • Date.
Permit #
y / N
Notes:
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
zoning to com fete Luc 1vj1vwir1
Violations:
Y/N
If so, List:
Proffers -
jX�CN
so, List:
N ce:
if so, List:
M 9/—,-/
SP's. )
If so, List;
Clearances.
SDP's
L
Revised 7/112011 Page 3 of 3
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PRO'V'IDED TO THE LANDOWNER
This form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations or Appeals, Sign .Permits, Building Permits) Yf the application is not the
owner.
I certify that notice of the application, .2,4� Vx , C..-.v
[County a ication name and number]
was provided to WJ 0 64 CLV`4-� PN (g. the owner of record of Tax Map
[name {s} of the record owners of the parcel]
and Parcel Number nu ) 2,o - 03 - ()o --a,) Z.4 J by delivering a copy of the application in. the
manner identified below:
Hand delivering a copy of the application to
[Name of the record owner if the record owner is a
person; if the owner of record is an entity, identify the recipient of the record: and the recipient's
title or office for that entity]
on
Date
Mailing a copy of the applicat onto WOO d-c-v-& p y--b p ,. fv- C-A- ,,., Q Y--,- u rYJ:
[Name of the record owner if the record owner is a person;
if the owner of record is an entity, identify the recipient of the record and the recipient's title or
office for that entity]
on to the following address;
Date
2- �1- �i I q +-I'- i t-. t1l) - U—) CAlA ,C,' c Lh� 2-Zsr O3
[address; written notice mailed to the owner at the last known address of the owner as shown on
the current real estate talc assessment books or current real estate tax assessment records satisfies
this requirement).
Signature of Applicant:
Print Applicant Name
5'- � -13
Date
Rebecca Morris ~Fire Rescue
From: Shawn Maddox
Sent: 16.20135:23pM
To: Rebecca Morha - FireReacue
Subject: RE: your approval for 3 clearances is needed
All three are approved since they are kJbe permitted by our offioe.
Shawn
From: Rebecca Morris -Fire Rescue
Sent: Wed 5/1S/2O1311:54AM
Tm: Shawn Maddox
Subject: your approval for ] clearances ianeeded
FM Maddox,
Please approve/disapprove andcommentreganjin0ottanhedtho3Zoning[1earanceAp of email bome. iwN|
sign and attach your response to the application and return it to Community Development in your absence.
As Linda Shiffiettms well. We've scheduled her Fireworks Retail Permit you
for 06/2712013 at1F`M beginning first at 200 po bop Center, followed by the locations Seminole Trail. She's going to
submit to us the usual paperwork as soon as its completed (property owner permission, list of fireworks to be sold, copy of
|nsurenca). She's had the same permits at these locations for the past several years. She ia using e pop-up oaOop!� not atent.
Thank you,
Rebecca Morris
Fire Rescue Department
Extension 3101
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