HomeMy WebLinkAboutCLE200700264 Legacy Document 2014-04-28L 1
Zoning Clearance
Boning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
Tax ntap and parcel: O v OV R/d _i�130 0 Existing Zouin6: �! _
Parcel Owner: D1 JCLAe_ 9-6. ,Ae- •SY°' o • )
Parcel Address: � G Up,.
—e-Lb. ` s ' `Gty City �-Lb. ~'� "�'kt1i�� State '�a Zi[�
'
(include suite or floor)
Contact Person .(Who should we call /write concerning this project ?): �r(1.� fVt �a ..„r � 1�.� �" �.l d�._:3[� ✓� i �'.; .
Address City :Z- State -? - Zip �
t` tj
Daytim me, `i
Phl Yt`4 1600 ° )57%r �.T'ax # . �,�r l V E -mail e d /so �
ca I to he, �prti.tc�-
Business Name /Type:ldlatf� f:r9h,t.3 1 r0. _
Previous Business on this site:
Proposed use. k t•? €-ems
k
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 r st f my kno ed e. I have read the conditions of approval, and I understand them, and that I will
abide by tern,
17 0%�� 1049h - oj
Signatur ofnusiness_Qwner or Agent Date 1� oZ
Ott..t P i►►//�i,, �Gt,I1. l I _7f07
Print Name
APPROVAL INFORMATION
[ ] Approved as proposed I [ Vpproved 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 rota determination of compliance with the existing site plan.
[ ] This site,eomplips with the site a was of this date. '9 11MI �
n ., .- nt . _ .. . i t4 A w _ , i . n t . A . i n l 1 /i /L1 �.. n. O/J A A /)1JeY1�
_q4 —
Building Official
Zoning Official
Other Official
Date is
DateL
Date
FOR OFFICE USE ONLY CLG # -
Fee. Amount �S Dalc Paid A4B who? / GL/V/ Receipt 11 A q?w 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 of4
Applicant to complete the following:
Do you have one of the following?
W/ 'ES ❑ 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.
coning Tech to c
Violations:�/
❑ YES L� N0
If so, List:
the
1ntaKe LU CURIP1CLe LIM luiturrittb:
YES ❑ NO
Is use in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
❑ YES [910
If so, give applicant a Certified
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 [�IO
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
Healtli'Dept, FAX DATE
S ❑ NO
Is on public water and sewer?
❑ YES [9'-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 # /DD 41L—�'
❑ YES E�-90
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
❑ YES FLrNO
If so, List:
Variance: � SP's:
F-1 V YES X0 0 YES ❑ NO
If so, List: If so, List:
—L4 6, �G �s
Square footage of Use: .j6
❑ YES ❑ NO
Permitted as: Z 44—qA
Under Section: • a l
Supplementary regulations section: 4A
Pat•lcing formula: �/ �� bllX''�� `�' �- ` `�'�'`%'
Required spaces: -Ii1�l
❑ YES ❑ NO
Items to be verified in the field:
Inspector Name & Date:
Notes
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