Loading...
HomeMy WebLinkAboutCLE200700253 Legacy Document 2014-04-28Application for Zoning Clearance ❑ Zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS Tax map and parcel: t A/t JI.S L Sic • 2 P' Parcel Owner: V/ a- ✓) d &_ r // , L i'/ COGS 3, 4/) 4/°I_ / Y Existing Zoning: 6 61S //I } , Ti^J(I— - P 0s(f 0 ,, Parcel Address: J S 6 °/ �= �il�J0GC- 15C --,2.e&--City (,,, 2L° T7---s urccc State Zip Z 2 q61 (include suite or floor) Contact Person (Who should we call /write concerning this project ?): /mil 7, 2 CY C r � , /r n C Address 'Faz o �j ,02 ,1u1- /L, (�a 6,0 " /City L o r rCCSt// CCEState Zip Z 2 90 a r(h l e �C Daytime Phone ±_3 �`� ' d a8 Fax # `�3 2 1 E -mail C'�' 1 'I fl Business Name /Type: Previous Business on this site: `"�L — ��v�C✓il o Proposed use: i �} ✓zlL) �'Glt/��/v1 �o,l� �fGL S �L ��CC - /��✓.O J-S- /d /A Al a✓ : 2t�.Jy -�� �ias�r✓c� ss 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 locatioii, 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 t, VE %2 o f 2 6 Signa�r1e of Busin s Ow r or Agent Date , /1.c-,— Ua n G`' Print Name APPROVAL INFORMATION [ ] Approved as proposed [ proved with conditions [ ] Backflow device and /or current test data needed for this site. Contact ACSA 977 -4511, x119. f ] 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 title, site pl n a o this date. - �Parfc'n y �/: L:,FrN k5,,l1r�vni c ru f{c s ;vtc �:ca(eGIaHS� .�h(�/apt ' Tvuck gG{rlcrr� -Iq ire esI $4 %UlAiInIg 5�2. Yb Va�istor ��I`K q{' P`1ss a UFV2�1 CI{�5 �c/ ipm�►1 0/' chi r�or �la � C c7� %e lI ,i I vvkp- 4�¢r rto Cifficial lllate Zoning Official Date Other Official Date FOR OFFICE + ONLY Fee Amount $ Date Paid CLE y who? Receipt #��Ck# 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 A'bplicant to complete the following: Do you have one of the following? M YES ❑ NO Tax Map and Parcel Number and or; Address of use (include unit or floor if appropriate) ❑ YES ❑ NO A/ " �czu : On <3 iZ, 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. Intake to complete the following: ❑ YES ❑ NO hV C) S C: Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet, ❑ YES ff NO 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 E� 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 Q YES ❑ NO Is on public water and sewer? ❑ YES P NO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑ YES [3'NO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # ❑ YES [f NO Is this for sales of Fireworks? If so, obtain a copy of F/R permit. Permit # 5 P Zoninufl'ech to complete the followinLy: YES ■ NO ITVM Variance: © YES NO If so, List: Proffers: ❑ YES If so, List: SP's: ❑ YES NO If so, List: 511106 Page 3 of n r 1 R(,viewWto complete the following: Square footage of Use: [2/YES ❑ 0 Permitted as: Sam, W Under Section: J�l� �'J �'� �, 04 '�� Supplementary regulations section: (� ( Q Parking formula: 40- 1 lArGb a ydA 4- Requi ed spaces: `'�► ` , YES ❑ NO Inspector Name & Date: Not is 5/1/06 Page 4 of 4