HomeMy WebLinkAboutCLE200700088 Legacy Document 2014-04-28"K (i1�1t ` .ae�.�ti"` �'�o'•r P �..G'� -
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Application for Zoning Clearance .
OFFICE USE ON'T1'Y %� T - Orb
S Zoning Clearance - S35 CLE # l- 0 6
PLEASE REVf W ALL 3 SHEETS Check# Date:
Receipt # Staff;
PARCEL INFORMATION
Taut Map and Parcel: �� / C�r�d f ` C) �'o Existing Zoning
Parcel Owarr: CC L.
Parcel Address: �T� Gi.��'C'�2'6� �'E'— P Y , Ci,y CL,.F(y f4�, V 16tate 4 Zipiz f I
.f ine ludesuiteorfloor) .............................. - - -- - -- ._ ---------- • ----------------------------
.,--
> - PRIMARY CONTACT l
Who should we call/write concerning this project?
SJ�� / / _
Address ;_ l ��5 `a' fi :7� /� City C1w.Tio��l`��11 estate / Zip 22 `ICJ2
Office Phone: l�l � ` - d��Cell 0 44 Y' V -ggFax # �� �1( ���� niI 2`Z[ = a�b -he-t
PROJECT INFOILMA��0 � -- �`���----- ;- p - - -,/ - - -�,�, � -
Busiuess 1Name)Type: v' f r ✓Y
Previous Business on this site.
Prnnns�etil ryae- �� °r� -l��v rd
5,V\
I
oil act ",\,.'1
to
Circle (if applicable): Fireworks / Christmas Tree
SEE CONDITIONS OF APPROVAL IF TIE CLEARANCE 13 FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet 1)
wM2 Clearance will only be valid on the parcel for which it is approved. if you change; intensify nr movo the use to a new location, a new Zoning
Clearance will be required.
1 hereby certify that I own or have the owne'S permission to use the space 'indicated on this application. 7 also ceitifq that the information provided is
true and accw%tc to the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will &hide by them
Signature
Printed
---------------------------------------------- r_..._---- vv.._-- ----------------------------------- 1 -- 1-_-._ - -- - - -- - - - -- _ ...
APIMOVAL INFORMATION ....
[ Approved as, proposed [ j Approved with onditiom
[ ] Backflow device and/or current test data heeded for this site. C'ortact AC:SA 9774511, xl 19,
[ ) No physical site inspection has been done for this clearance. Therefore, it is not a determ ination of compliance with the existing
site plan.
[ ] This site complies with the 8ke plan as of this date.
Building Official Date
Zoning Official Date
Other Official Date
-. ........................... - - - -- - - - --- County of Albemarle Department of Community development - --
401 McIntire Road'Charlottesville. VA 22902 Voice: !4_ -341 296 -5932 Fang: !4341 972 -41126 to /ta /n5 Pawn nFd
v c�
y
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Applicant to complete the following:
N
�
N
have one of the follawiiig?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
V lN
ou have a Floor plan (sketch or an archi:ectiral 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 stmeturre; note the location witv'tin the
S��o�C�CJ1. '� S�
: oning Tech to
Wiotis:
Y
If ; List:
Y `lam
If so,
lete the
Intake to complete the following:
Y / N,
Is use iii U, FIT or PD1P zoning, If so, give applicant a Certified
Rngineer's Report (^ER) packet.
NO
Will there be food preparation?
If so, give appliL=t a I- icalth Department farm.
Zoning review can not begin until we receive approval from
Health Dept, PAX (DATE
r
Is p i an 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
1/ N
on public water and server?
V N
l you be putting up a new sign of any kind? If so, obtain
proper Sign permit���
Permit #
V il N
l there be any new constniction or renovations'?
If so, obtain the proper Permit.
Permit - -/') ze'�' &c'
�✓ ��Pis
/(,�
TY s th is for sales of Fireworks?
If so, obtain q cony of F/R permit.
Permit #
ffers:
so, List:
V/ N
If so, List:
I Of 14105 Page 3 of
}
Reviewer to complete the io 1 g rz O m
Square footage of Use;
-
N � �a�rc�,vvavp,
znitted as;
Under Section:
Supplementary regulations section:
Parking formula: / � —
Required spaces: —
'Y /N
Items to be verified in the field;
Inspector Name & Date:
Notes