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HomeMy WebLinkAboutCLE200700191 Legacy Document 2014-01-22Application for „ Zoning Clearance o -xNP oning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS Tax map and parcel: l: 0 5�F I -- 0 !� — C) c © oz/0 6 Existing Zoning: � -- Parcel Owner: AL 5 5,�1 1 Al J IP ,a✓ Parcel Address: ;-,1_75 � /-A/. City CNA 4l e V� 1 1q, State -7q zip '47-911 (include suite or floor) �. Contact Person (Who should we call /write concerning this project ?): Address Q :: '-) -c. Y+,% i in a � t _cry City C -- IMt— State \f V) > Zip G Daytime Phone U "7 3 — `l 1/ S-`/ Fax # (y3"' 9 3 i"1 B D E-mail'-9,\, a14. v- A\ tNn ",A.7 9 t e v%% Business Name /Type: n" s v. t. FN (�o cr V Previous Business on this site: OR V�,c4 , C_ t_1 "r :) It c+I \ It, — Proposed use: 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. _ X .,er '? — '21 7 Signature of Business O�>wn\e°� or Age�nt Date , _l- Print Name 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' Zoning Official ; � Date _410? Other Official Date FOR OFFICE USE ONLY CLE # Fee Amount $ ±?Q Date Paid 2.2 By who? L Receipt #4( % CAW0-6�_\ By: 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 Applicant to complete the following: Do you have one of the following? [/� YES F-1 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 location within the structure. J Tech to complete the Vi fations: YES ❑ NO If so, List: '411 �� n Variance: - YES ❑ NO If so, List: ' �� •�aL C-1 Intake to complete the following: ❑ 1 YES .0 NO Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. ❑ YES kfo O Will there b preparation? If so, give applicant a Health Department form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE ❑ YES ZNO 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 [YES [:1 NO Is on public water and sewer? Z YES ❑ NO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # •2 o J-Z `" 13 5G 4 YES F] NO ll there be any new construction or renovations? If so, obtain the proper Permit. Permit # 2c> b "7 ❑ YES �� NO Is this for sales of Fireworks? If so, obtain a copy of F/R permit. Permit # Proffers: ❑ YES ,® NO If so, List: 4 YES ❑ NO QQ' If so, List: o — c( 3 5/1/06 Page 3 of 4 C Reviewer to complete the following: Square footage of Use: 237'2-° l��A %' A-Zo7c, YES ❑ NO 1 Permitted as: A w l ki iv ,i��Y A,15 5A 1 C5 Under Section: �7— / -� ' Supplementary regulations section: Parking formula: �' l o /' J J Required spaces: ❑ YESNO Items to a verified in the field: Inspector Name & Date: Notes 511106 Page 4 of 4