HomeMy WebLinkAboutCLE200700125 Legacy Document 2013-12-12A
Application for Zoning Clearance
OFFICE U 0
El Zoning Clearance = $35 CLE #
#
PLEASE REVIEW ALL 3 SHEETS Check Date:
_ W6'_i4J
Receipt # Staff:
PARCEL INFORMATION
Tax Map and Parcel: Lf.S7 16 9 0,)-- Existing Zoning •
Parcel Owner: s8y, C w e
Parcel Address: City C" V1 � �4 State V, A zip
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_X��f i - A N_ T 1 (include -0 RMAT 10 N
Who should we call/write concerning this project?
Address: �Lfa 'tdAtJca V_A City r1qS"','0e_ —State—VIA Zip2 Xc?.3 6 -
Office Phone: L41,4) --7,Q --I ILI 6 Cell# Fax # E-mail C 'konor:z &_ i-401' cot"
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PRIMARY CONTACT
Business Name/Type: _ Arced F-oac'c 'Ny S)-f�it SAW<
Previous Business on this site:
Proposed use: USA IX -P.JL i90_C'T_ pQr4tie I ve"%'IQ
6, C'Ay '-JL lv"J� Play,L", I P_AL�'vc 044VC . PQ6V-'6V""?& -F
Y _V�vs' P , i
A Ji, Ycen'4 S� b' ego, h
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 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.
2
Signature A f'SA Printed— a e,
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APPROVAL INFORMATION
pproved 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
site plan.
[ ] This site complies with the site plan as of this date.
Building Official
Zoning Official
Other Official
.Date
Date
Date
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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
Applicant to complete the following:
0 o N
you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
Do you have a Floor Plan sketch or an architectural drawing) that
Y ( g)
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
Viol ns:
Y/
If -st:
Vari
Y/
If so, � st:
the
Intake to complete the following:
Y /see''
Is u m LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
9/28/05 Page 2 of 4
If so, give applicant a Certified
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
Y /0
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
/N
on public water and sewer?
Y /0
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
YINO
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Y tkr�
for
Is s sales of Fireworks?
If so, obtain a copy of FIR permit.
Permit #
Pro rs:
Y(/
If s , List:
SP'
Y
If
Reviewer to complete the followin '
Square footage of Use: � s � ,L ,D QAla ,j Y9'►.
Y/N f
Permitted as: Ac-,e Q,1/ /
Under Section: dX M , J2
Supplementary regulations section:
Parking formula:
Required spaces: �e MJ� e,/ & e�
Y
Items o be verified in the field:
Inspector Name & Date:
Notes
Y /6tS /VJ rage J or 4
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