HomeMy WebLinkAboutCLE200700094 Legacy Document 2014-04-282
Application for Zoning Clearance �� m
I�Ir1lP
OFFICE USE ONLY `/
❑ Zoning Clearance = $35 CLE # ptbti�/ 9'Y
PLEASE REVIEW ALL 3 SHEETS Check # / 9b • Date:
Receipt # f i2gQ Staff:
PARCEL INFORMATION M21 Tax Map and Parcel: '/ 75 LQ • Existing Zoning
Parcel Owner: Nk
Parcel Address: q-70 A'/-41-) P JL -6
(include suite or ffoor)_ _
APPLICANT INFORMATION
Who should we call /write concerning this project?
City c y \' � k- State
V-C
rL
M
Zip
Address:. (-V q lit T -V14 City C V l - State VA Zip
-0ffrce Phone: (H!`) fell # Fax # E -mail
5 o00 pA10q' Z.Z90'-
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PRIMARY CONTACT
Business Name /Type:�;'S
Previous Business on this site: 1
Proposed use: a —,654
Z"Z` 0 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 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.
Signatur /01,1 �`"" vim- Printed -0-
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APYiROVAL 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
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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:
N
`D /o you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
�0/ 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.
., oning Tech to
Violations:
If sd ��
'Mist:
the fo
9/28/05 Page 2 of 4
Intake to complete the following:
Y /Oi
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y /� N/
Will 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 /NO
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 ou be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
Y /O
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Yi)or
Is t sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers: V
Y
If so, List:
Varian e: SP's:
Y / Y �
If so, List: If so, ist:
Reviewer to complete the following:
,Square footage of Use:
Y/N
Permitted as:
Under Section: c.e.
Supplementary regulations section:
Parking formula: %q ^'.s C.& C- �� •�✓
Required spaces: �,�, /fir✓
Y / �T
Items to be verified in the field:
Inspector Name & Date:
Notes
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