HomeMy WebLinkAboutCLE200700212 Legacy Document 2014-04-25I -
f Application for
Zoning Clearance
❑ Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
Tax map and parcel: �A�w Existing Zoning:
Parcel Owner: �y �� A. �i 3 ✓t bc�Z��c%1^-'
Parcel Address. ` f% �f�j�city
(includes ite or floor)
State yrf Zip I2
Contact Person (Who should we call /write concerning thins project ?): FrI1 01 1Lad �c,,i:h
�' �/fp U � city �� Address 9/5 5 -46 State V it Zip
Daytime Phone (O
124 - %96e4ax #& E-mail �l G�- h�1tt� 1►►��� C�t>��Cal
�(} 'TdPe Home 110,r1n eD
Business Name /Type: �RC�� r 5e r d ice 1^i6t7nr ) 14CL r�MA m 1�Ilome I\t?rio- vat;
Previous Business on this site:
� `C,r +�(/�1i0.1
S
�Oi ti �C Sr►- ,;pro¢,PC?o� r n `5
Proposed use: (�PAo-G �PQcP_
--1-c>r^
kepa�
r- ` ery iC_'1
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.
. l
Sigilature of usiness 97ner or Agent Date
Y\ft4ko 5 Ke- I 1 5Gill
Print Name
APPROVAL INFORMATION
[ ] Approved as proposed [ P-A-p-proved with conditions
[ ] Backflow device and /or current test data needed for this site. Contact ACSA 977 -4511, x 119.
[ ] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing site plan.
[ ] This $ite complies with the sit plan a of this date.
�wn
V V
Building Official Date '1
Zoning Official Date
Other Official Date
FOR OFFICILUSE ONLY 04AAIA11 CLE #
if � Fee Amount - Date Paid By who?
-
o Receipt 1169 Ck#
By:
VAI
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 of4
A. licant to complete the following:
PP P g:
Do you have one of the following?
❑ YES �NO
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate)
❑ YES [R 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.
l-
I ,� X I z) tLrl 'cc 5?�-ce
M
Zoning Tech to complete the following:
W, 110M
Intake to complete the following:
❑ YES [�'-NO
Is use in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
❑ YES NO
Will there be ood preparation?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from
Health Dept, FAX DATE'
❑ YES [�10
Is parcel on p��``i'vate 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?
❑ YES N.--NO
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
❑ YES [��t0
Will there be l ny new construction or renovations?
If so, obtain the proper Permit.
Permit #
❑ YES NO
Is this for sal s of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
❑ YES &2ZNO
If so, List:
Variance: S '
❑ YES [NO ES �—n10�
If so, List: f so, List:
Y
County of Albemarle Virginia
a�
County of Albemarle Virginia, USA
fill '�'r
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Parcel ID
05600 -00 -00 -08700
Left Image Sketch
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Address
5155 THREE NOTCH'D RD
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August 23, 2007
COMIllullity Developynent Deparlancnt
Division of Zozlin.g and Current ent
401 McIntire Road
Cbarlottes"We, Va.. 22902
Subject- CLE 2007 -212
To the County E».gin.eer,
I a.tn. a shall. repa - business ,for .home tnproveiinents, such as painting, wall.
Papering etc. T have no ern ..ployees at this tune. T azn .zequesting the use of one
small office, approx. 12x1.4 space for cl.erica..l tracking of my business only.
1 have addressed the perforrn.ance standards of Zoning Ordinance Sectiola. 18-
4.14:
Noise: My operation will, not create sound or impact ».oi.se levels in excess of
the values specified i». section. 4.:1.4.1. My m.ajox sources of tao.ise wi,1.1 be '1,)
tcl.eph.one .
V.ibrati.ou: I operate ..no equipment at this site,
Glare: My operation is conta.ined within the building. The interior lighting
associated with, tlid.s office space does not produce glare tb.a.t is visible beyond
the lot l.in.e.
.Air Pol.lutXot .j: There wi,l.l. be uo emission of srnoke, odor or gaseous
polluta.tlts,
Water Pol.luti.on.: No .Liquid waste will be generated by any operation. My
operation. does not represent a hazard to water duality.
Radloachvity: My operation. does not require halidling of radioactive
rnaterials. There will be no radioactive ernissions.
Electrical Interfer '
ence,
MY operation does n.ot require any eqp,
qu ipment fl,).a,t
wotd,d generate electrical. disturb aIaces.
Please .feel ftee to contact me with any ffifther questi.OnS you may .lave at
(434) 996-3228 or (434) 823-2040 ein.a.11 address laa.rt. lanholn .. I yol cote
Stncercly,
T4,bfl J.
Kathy S. KellISOD.
5155-b three notcb.d rd
Crozet, Va. 22932