HomeMy WebLinkAboutCLE200700289 Legacy Document 2014-04-28Application for 0J.",
Zoning Clearance
ding Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
Tax map and parcel: Q -1(joc) .- oo- 00 - ®`3 00 Existing Zoning: L G16't t1CJU• ^�I
Parcel Owner: V �- O( R'QWQr1Ct, N1 , 5<rs -A-D
Parcel Address: i Ci (O-L noz 1oi,1 L, City C\nt C o- 1J 1"` State V Zip 22402
(include suite or floor)
Contact Person (Who should we call /write concerning this project?): �Yl C �. 1`'l'i�l I(�i
Address 1 l �t 1� I�t�P .• City l� Jb A t!Sw1q-[? State �/X_Zip.J0Jq0Q
Daytime Phone 4Z& ',-r)' �i ~ 0a)-l0 Fax # - CQ[CI E -mail Cf_ IQ C0) hQ{'MQ(l. i
Business Name /Type: S nt kdnc 9 Inc-,
Previous Business on this site: Yl uJ t--Wt 16 l
Proposed use:
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet 1)
Circle (if applicable): Fireworks / Christmas Tree
*This Clearance will only be valid on the parcel for which it is approved. If you change, intensify or move the use to a new location, a
new Zoning Clearance will be required.
I hereby certify that I own or have the owner's permission to use the space indicated on this application. I also certify that the information
provided is true and accurate to the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will
abide by them.
[re of Bud ness Owner or
� . . .1?
Print Name
APPROVAL INFORMATION
[lVfApproved as proposed
[� ] Backflow device and /or current test data needed for this site.
[ ] No physical site inspection has been done for this clearance.
[u],T(iis site complies with the site plan as of this date.
Building Official
Zoning Official
Other Official
((6 Ian
Date
[ J Approved with conditions 13cas;o' k't� 0
Current ,Fes$: .h., n
Contact ACSA 977- 4511, x119. C0zlt,, ^s' , `.'`'t' 7;
Therefore, it is not a determination of compl ance`with the existing site plan.
Date ( 1
Date
Date
` It
FOR OFFICE USE ONLY CLE # 7'' AWE � : 2
Fee Amount $�JC' CQ Date Paid ' , -6 :2 By who? i, "a'�a t Receipt # 1 i ", C k 4
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
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Applicant to•complete the following:
• Do you have one of the following?
YES [] NO
ax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate)
YES ❑ NO or an architectural drawing) that
Do you have a Floor Plan (sketch
includes the following, and if so please provide it with the
application?
The total square footage o
The square footage 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.
to complete the
violations,
❑ YES �NO
If so, List:.
Variance:
❑ YES o NO
If so, Lis .
1nxmm to jjA} IMC C11G 1Vi1V�► +++�•
ES ❑ NO If so, give applicant a Certified
Is use in LI, HI or PDIP zoning?
t
Engineer's Report (CER) packet. '/f f/
❑ YES.
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 L 0
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
[LI, s a NO
Is on public water and sewer?
❑ YES ❑ NO
Will you be putting up a new sign of any kind? If so, obtain
Sign permit. 1 %
Permit # Z.
❑ YES ❑ NO t L� IQovvlLA
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
❑ YES LS90
Is this for sales of F r f Fw p wit.
If so, obtain a copy
Permit #
Proffers:
YBs N4
if so. List:
SP's:
'Z YES ❑ NO
If so, List: /
5/1/06 Page 3 of 4
)Reviewer to complete the following:
Square footage of Use: ! 5 5
j;j YES ❑ NO
4 Permitted as:
Under Section: .2
Supplementary regulations section:
`d'� �' X ✓uiS
Parking formula:
Required spaces:
❑ YESF5 NO
Items to 6e verified in the field:
Inspector Name & Date:
Notes
5/1/06 Page 4 of 4