HomeMy WebLinkAboutCLE200700086 Legacy Document 2014-04-28- - _ - - - (include suite or floor) .................................................
APPLICANT INFORMATION %�
Who should we call/write concerning this project? 6, h
Address :44-1 `y -,C)y eA City 6) `tom State V'CL— Zip J- J4?6(D
Office Phone: ( ) (� W � -COD I Cell # � 'U'� "� �� Fax # %,( ' o Z�l9 E -mail ( .0_C i on � tL �s11CU �U1L
- - - - -- -- -- - - (� ---- ONT--------------------------------------------------------------------------------------------------------------------------
PRIMARY A- C__ + 1
Business Name /Type: Gk 6:50 1 C ru\,�_to (� _i _
cl
Previous Business on this site:
Proposed use:
Circle (if applicable): Fireworks / Christmas Tree
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet 1)
*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 accuratto the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed Lc -c G' L-,°-r�
--------------------- ---------------------------------------------------------------------------------------------------------------------------
AP )PROVAL INFORMATION
Approved as proposed [ ] Approved with conditions
[ ] 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
Zoning Official
Other Official
Date
Date
Date
------------------------------------------------------------------------------------------------------------------------------------------------
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
-D-7
_ ..
Application for Zoning
-
Clearance
l�jR,GLNIP
Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY
CLE #
Check #
Receipt #
Date: rJ
Staff.
PARCEL INFORMATION
Tax Map and Parcel: AU
' 0� - (X_1 - 00 gm
,
Existing Zoning (i
Parcel Owner:
Parcel Address: S = nL�rn(P l�CZ��
City t'_imlj)d &e Vo
��_State
Zip Z2`16
- - _ - - - (include suite or floor) .................................................
APPLICANT INFORMATION %�
Who should we call/write concerning this project? 6, h
Address :44-1 `y -,C)y eA City 6) `tom State V'CL— Zip J- J4?6(D
Office Phone: ( ) (� W � -COD I Cell # � 'U'� "� �� Fax # %,( ' o Z�l9 E -mail ( .0_C i on � tL �s11CU �U1L
- - - - -- -- -- - - (� ---- ONT--------------------------------------------------------------------------------------------------------------------------
PRIMARY A- C__ + 1
Business Name /Type: Gk 6:50 1 C ru\,�_to (� _i _
cl
Previous Business on this site:
Proposed use:
Circle (if applicable): Fireworks / Christmas Tree
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet 1)
*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 accuratto the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed Lc -c G' L-,°-r�
--------------------- ---------------------------------------------------------------------------------------------------------------------------
AP )PROVAL INFORMATION
Approved as proposed [ ] Approved with conditions
[ ] 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
Zoning Official
Other Official
Date
Date
Date
------------------------------------------------------------------------------------------------------------------------------------------------
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
.Applicant ,to complete the following:
/
l o yN ou have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
o )N
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.
Tech to complete the
Violations:
� / N
so, List:
Z—
r
Varia ce:
If /
If so—,List:
Intake to complete the following:
Y G
Is use in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
9/28/05 Page 2 of 4
If so, give applicant a Certified
Y
Wil 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
Y /6
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
-7 /N
Is on public water and sewer?
Y /(N)
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
Y /
Will e be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Y Aor Is sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
Y/`�
If so—, fist:
.S s:
/N
If so, List: �► g /� ,�/
Reviewer to complete the following:
Square footage of Use: M_ l
1 N J
ermitted as: -7(-,,,,_,,
Under Section: ,� � . or , (�
Supplementary regulations section:
Parking formula: ✓l- �I `C.. ?t AI
Required spaces:
Y /4:0),
Items to be verified in the field:
Inspector Name & Date:
Notes
7 /L2S /UJ vaae j Or 4
j%22S /u--) vage 4 of 4