HomeMy WebLinkAboutCLE200700087 Legacy Document 2014-04-28Application for Zoning
Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
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earance
reed
OFFICE USE ONLY
CLE # z d O 7 9
Check #� Date: - % Z °5;-7
Receipt # (dam% Staff:
PARCEL INFORMATION ' 0
Tax Map and Parcel: Existing Zoning 14 L L) "J ix /r%
Parcel Owner:
Parcel Address: 7 � 7 / � � ,� City C>/1- i.�tI� State Iy E',r� Zip
- (include suite or floor)
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APPLICANT INFORMATION
Who should we call/write concerning this project? t—a )1t
Address : ��r� 1�l��CLt'i'd R City ��%�A State a C- Zip C�
,�u, ��3�
Office Phone: t 71 Cell # �S� —u1(3 Fax # E -mail
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PRIMARY CONTACT !2j Business Name /Type:
Previous Business on this site:
Proposed use: _ Z- _A. C L% f U r1V L-
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 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.
Signature w J r 1 f4 +'� Printed CA lm
-- - - - - -- - -- ` ----- - - - - -- -------------------------------------------------- - - - - -- ---------------------------------------------
APPRO- --- VA- L ---IN- - FO- - -- RMATION
[ ] 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 skplan as of this date.
Building Official
Zoning Official
Other Official
Date
Date
Date
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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:
Y/N
Do you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
Y/N
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.
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, oning Tech to
Violations:
Y/N
If so, List:
the
Intake to complete the following:
Y/N
Is I, HI or PDIP zoning?
Engineer's Report (CER) packet.
9/28/05 Page 2 of 4
If so, give applicant a Certified
Y/N
Wi ere 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 L._/
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
) N
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 # V
Y/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit # 0
Y/N
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit. %
Permit # � V
Proffers:
Y/N
If so, List:
Variance: SP's:
Y/N Y/N
If so, List: If so, List:
Reviewer to complete the following:
Square footage of Use:
Y/N
Permitted as:
Under Section:
Supplementary regulations section:
Parking formula:
Required spaces:
Y/N
Items to be verified in the field:
Inspector Name & Date:
I Notes
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