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HomeMy WebLinkAboutCLE200700092 Legacy Document 2014-04-28a� Application for Zoning Clearance �tf rA E�Z�� �r n OFFICE USE QNLY ❑ Zoning Clearance = $35 CLE # % - 92�� PLEASE REVIEW ALL 3 SHEETS Check# Z&1,91p Date: 4117-67 Receipt # (AU)R' Staff: CSM PARCEL INFORMATION �---� r� dM - 23 ,1QC�L Existing Zoning �, D Tax Map and Parcel: A b Parcel Owner: 14)OMON� Parcel Address: 120�-C wE JD�?.twLS oath City lctE State Vi4 Zip�2 (include suit or floor) --------------------------------------------------------------------------- --------- - - - - -- ---------------------------- ------------- - - - - -- -- APPLICANT INFORMATION '_R r � -um Who should we call/writ'elconcerning this project? Address : 2 % � (writ city State �VA /Zip 2603 Office Phone: 34 - QS Cell # Fax # " 1462 E -mail JJad • �2 C� lF1LuGl4rL 44_s . COM -------------------- ----------------------------------------------------------- - - - - -- - PRIMARY CONTAC� / '� Business Name /Type: �CLyC�4+2 /' / I AL� 1Me aJ 4L — �J2onytT' JEUEIoph007 RS64KXL! Previous Business on this site: Proposed use: a 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 ormove the use to a new location, a new Zoning Clearance will be required. I hereby cer%toe ve owner's permission to use the space indicated on this application. I also certify that the information provided is true and accmy Fl d e. I ave read the conditions of approval`, and I understand them, and that I will abide by them. Signature Printed I�t7I�E/� lIi�.r�' - ------------------ - - - - -- - -------------------- ----------- - - - - -- -- A7ROVAL INFORMATION [v] 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�,pIan. [VI This site complies with the site plan as of this date. .e r Building Official Date / (t --i Zoning Official Date i� IC d (07_ g �. Other Official Date County of Albemarle Department of Community Development AA1 'n ---7 :'�L....1..1- L......:11- t7 - 1-10n7 !A•2Al'704_r%Qg1 Fwv• ldAdl 077-d116 a Applicant to complete the following: ©/N Do you have one of the following? Tax Map and Parcel Number and or; Address of use (include unit or floor if appropriate; ®/ 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 complete the Viol ins: Ypslist: If Intake to complete the following: Y, N Is use in LI, HI or PDIP zoning? Engineer's Report (CER) packet. Y /© 9/28/05 Page 2 of 4 If so, give applicant a Certified 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 /© 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 J/ N Is on public water and sewer? Y /� Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Y/Q Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # YIN Is this for sales of Fireworks? If so, obtain a copy of F/R permit. Permit # /N Var' e: SPO—i Y Y Ifs ist: If st: