HomeMy WebLinkAboutCLE200700090 Legacy Document 2014-04-28A` licatio /for Zoning Clearance®
OFFICE USE ONLY Cl
F1 Zoning Clearance = $35 CLE # 7 C> ®� `— I Q
PLEASE REVIEW ALL 3 SHEETS Check # 0010J7 Date: — % _ 0.7
Receipt # (p J (7 j Staff•
PARCEL INFORMATION Qj
Tax Map and Parcel: I Existing Zoning H W °�j co vlq ry-a
Parcel Owner: G5 7
Parcel Address: � � -%�W City State r'- Zip 07Z O J
_______ ___ _______________ (include suite -- --- - - _____-
APPLICANT INFORMATION
Who should we call/write concerning this project? l� ^C%AfG /N ,f—kO G�7
Address: 17 -f5 z �Z City a, d <L//-- State �/',¢ Zip _,E2 911
Office Phone: '?W e_ell # 21 q Fax #
�71v0_ Ind �
E -mail `fDNw abb,eEh Arc-1 @ 6011k,l -W -CCM
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PRIMARY CONTACT
Business Name /Type: +0 Z: +A-161 Sf^ p V � C/=
Previous Business on this site: Sf kGVb� �fh5 62�i4,� 2c�
Proposed use:
v t�Q
Circle (if applicable): Fireworks / Christmas Tree
/D 41
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 t e conditions of approval, and I understand them, and that I will abide by them.
Signature L Printed Zffi_ :/,624Z • �'S.�G �/S �C�
----------------- V -------------------------------- ---------------- - - - - --- ------------------
INFORMATION
[ ] Approved as proposed ed 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 com lies the s'te plan as o
Building Official
Zoning Official
Other Official
Date j �I tj-I
Date 3 /J
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:
CV/ 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.
Tech to compete the
Violations:
�S/N
,List: ! D3,3 N6 V 1 `6
c
f S ria nce:
N
o, ,jst: `
9/28/05 Page 2 of 4
Intake to complete the following:
Y N
Is u ' LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y /a
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 .
Y /('�"1 G
Is par a on pri ate well septic?
If so, give apple ant a H al Dep ent form
Zoning review can not b in a receive approval from
Health Dept. FAX DATE
Y Pbe
oand sewer? , M
Y / �( �'
Wil g up a new sign of any kind? If so, obtain .
proper Sign permit.
Permit #
Y /�
Wi re be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Y
Is Uor sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Prof e
Y/
If so, ist:
%Y)/ N
'If �O List: _
Reviewer to complete the foll o wi ng
Square footage of Use: / i
Y/N
Permitted
Under Sec
Supplementary regulations section:
Parking formula: I L,-)-o 6
Required spaces: oCu
Y /
Item to be verified in the field:
Inspector Name & Date:
Notes
y//-aiuD rage j or 1+
i %l2S /U5 Page 4 of 4