HomeMy WebLinkAboutCLE200700241 Legacy Document 2014-04-28Zoning Clearance , �'�
/Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
Tax I1i711) and I)II1 -ccl: �P / " !�� Existing Zoning: P
Pareel Owner: ) � J j f
Parcel Address: 1-53 � \b 9J City C I o JAS JI c�� tate Zip ag��
(include suite or floor)
Contact Person (Who should we call /write collecruilig this project' ?):
Address �� City 1� iA-� �`1-t 1/���� /stater Zipv 1�
Daytime Phone 7t Z � "'T 5 !� rax # ( ) 20 l0 � / E -mail 1474e o �- r ui LIL 6� ea (W 1141
Business Name /Type: h 1 �e-41 I 0 n JL )
Previous Business on this site: ( / '1 /
Proposed use: grit I ( 1 0 1 / Z.1 )1i 2:
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Slieet 1)
Circle (if applicable): Fireworks / Christmas Tree
*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.
Sin u o usiness Owner or Agent Date
Print Name
APPROVAL INFORMATION
[ ] Approved as proposed [ ] Approved with conditions
] Backflow device and /or current test data needed for this site. Contact ACSA 977 -4511, x 119.
] No physical site inspection has been done for this clearance. Therefore, it is not a determination of cott)pliance with the existing site plan,
] This site complies with the site plan as of this date.
Building Official
Zoning Official
Other Official
Date I] c,, f,— r
Date
Date
FOR OFFICE USE ONLY CLE # .200 -7 77 qq / - —7 �+
Fec Amount R Dale Paicl� / By who'? � Tecipt 11 &7Q-1 Ckll 6 C / By: GCO
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 5/t/06 Page 2 of
,u �-
Applicant to complete the following:
Do you have one of the following?
[ YES ❑ NO
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate)
YES ❑ NO
o 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; ������(�` fj
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:
coning Tech to c
Violations:
❑ YES ❑ NO
If so, List:
Variance:
❑ YES ❑ NO
If so, List:
the followin
❑ YES NO
Is use in LI, I-II or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
❑ YES [3 NO
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
❑ YES :1 NO
Is parcel on p ivate 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
Co YES ❑ NO
Is on public water and sewer?
❑ YES ❑ NO
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
❑ YES ❑ NO
Will there be any new construction or renovations?
If so, obtain the proper Permit,
Permit #
❑ YES ❑ NO
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit,
Permit #
Proffers:
❑ YES ❑ NO
If so, List:
SP's:
❑ YES ❑ NO
If so, List: