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HomeMy WebLinkAboutCLE200600257 Legacy Document 2015-01-21pY AI Application for A b 15 7 Zoning Clearance ,�INhP Zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS Tax map and parcel: M/ �M X) — Z �3 " fdvL' e l Z Existing Zoning: Pu 1? Parcel Owner: Parcel Address: 17-01 1,1#- (include suite or City Clw ff y ? 5',w 7h-e- State.-.- Zip 22 0.2. Contact Person (Who should we call /write concerning this project.) �1 �� S�' � State V4 zip ,9 Z Address ��. � � � � U' �'- � f i ill R City G�,.l �,0 1 p �_ Daytime Phone t •" 743330& Fax # "3W q79- /733 E -mail S /vT a' S�-1 ✓rc�! mdr_S�?f 1�u • �'�1 Business Name /Type: CCE l d't Ce�G-S� O ,, n M / ©� �Sb lle-1 Previous Business on this site: A/G7n/C - Proposed use: �'i �f ericdLOS-L 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. - z /0. -;.f-0 6 ignatui e of Business OV44r or Agent Date l!t?, Print Name APPROVAL INFORMATION [' ] Approved as proposed [Approved with conditions [ ] Backflow device and /or current test data needed for this site. [ ] No physical site inspection has been done for this cle Fan [ ] This site compli s W`h the site gglan as o his_da � 60 It �a7LQ<, 011M1_ Q � Building Official Zoning Official Other Official Contact ACSA 977 -4511, x119. Lherefore, it is not a determination of compliance with the existing site plan. 63)-604 -2Z21 kJ L Cc _ Date 3 �t 6 _ Date 117 4 !l Date FOR OFFICE SE ONLY CLE A Fee Amount $ Date Paid y who? Receipt # &_Ck #111 �L— B County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 5/l/06 Page 2 of4 Appl icant Lo complete plete the folio ing: Do you have one of the following? [9 YES ❑ NO Tax Map and Parcel Number and or; Address of use (include unit or floor if appropriate) Ej 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; 1213,90 d 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. Zoning Tech to c Violations: ❑ YES IV I NO If so, List: Variance: ❑ YES [ 'NO If so, List: the following: Intake to complete the following: ❑ YES 0T NO Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. ❑ YES 5-M 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 [J'NO 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 ❑ NO Is on public water and sewer? O-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 # ❑ YES �] NO Is this for sales of Fireworks? If so, obtain a copy of F/R permit. Permit # EI YES El NO If so, List: SP's: ❑ YES If so, List: B-NO 5/1/06 Page 3 of .'ev `Ier to complete the Holding: 1 \lineli e ++ "; '•quare fbotage of Use: YES ❑ NO Permitted as: W Under Section: 90 t, , Supplementary regulations section: Parking formula: I /e w , " tibO r G s�,nrrs `u 5e ate► Required spaces: ❑ YES ❑ NO Items to be verified in the field: 65' Inspector Name & Date: Notes 5/1/06 Page 4 of 4