HomeMy WebLinkAboutCLE200700266 Legacy Document 2014-04-281 1
Zoning Clearance
Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
Tax map and parcel: 6 3 ZOO tb CO 03 946 Existing Zoning:
I��IfCIN�F
I'areel 0wuer:
2 r, c;t _State �� zip
Pareel Address: . ii 1 x'� nee "04 J C
(include suite or floor)
Contact Person (Who should we call /write concernittg this project ?): GAIrLe") T, P`QBOY ` / r
Address (?OL - �E.f��1S Co'C�Q city m1OeSS�S State Y°— Zip .2fl1l0
D.nytimc Phone O3 S 3�i
Tax # � 3�`1 '-236 E -trail A P SC�J�f��ar� r-TC� C��M
BusinesslVame /Typ �ISCOJ�Q G��T��R3f-E✓, LLLI
Previous Business on this site: h1V'Jt4UC Jrn
Proposed use: S 6cXuro i't.t 40 1— 001P047k
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, Q
40, 9_`7.0 3-
Signature ofd�usiness Owner or Agent Date
Print Name
APPROVAL INFORMATION
[ ] Approved as proposed
J Approved with conditions
] Backflow device and /or current test data needed rot- this site, Contact ACSA 977 -4511, x 119.
J 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 i t
Zoning Official Date _/i / la 7
Other Official Date
FOR OFFICE USE ONLY CLC # 1 :� & �7I
Fee Amount $ `� (� ri^ Date Paid - who? %, �Ir o_ i.:.,. Receipt it Ck# f' 1 By: 10
0
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?
YES ❑ NO
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate)
f7 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?
Tile 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.
Tech to complete the followin
Violations:
YES ❑ NO
If so, List:
e) q
1nLaKe LU C:UM CM LIM 1U11UW111g:
❑ YES NO
Is use in LI, Hl or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
❑ YES ,® 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 0 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
XZ YES ❑ NO
Is on public water and sewer?
® YES El NO
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
❑ YES NO
Will there At y new construction ror�yrenovations?
If so, obtain the proper Permit. L.�► -�% /e. S�
Permit #
❑ YES NO
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
❑ YES NO
If so, List;
Variance: SP's:
❑ YES E/ NO �[/] YES ❑ NO
If so, List: If so, List: �>' Z-?
Square fgotage gfUse:
❑ YES ❑ NO
Permitted as: / 4 ��� c,
Under Section: Z 2 , 2.�
Supplementary regulations section:
r J
Parking formula: Z vC)v x • �V 0 J
Required spaces: �p �? �'"�VANS
❑ YES ❑ NO
Items to be verified in the field:
Inspector Name & Date:
Notes
:41 owro-01", 014�
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