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HomeMy WebLinkAboutCLE200700242 Legacy Document 2014-04-28Ala 1•�h�1' Zoning Clearance -MN� ❑ Zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS Tax neap and parcel: 0#75w— Do 60 — © 9 V bo Existing Zoning: Parcel Owner: NA (??.� (*e, J h n c V Parcel Address: 0c) �, , P j City C' G�ez , f WAS o ) e f y State � �9— Zip zz5yj (include su'te or floor) Contact Person (Who should We call /Write Collearning this project?): (- ��rr' to / IVI a 1 t t LS &I X V'I 4U Other Official Date (\,�J r �^ Addl'CSS i ` � a V ��.aU l� lJ I � t"� .—City �l �L % ] �%�//� ( �V `(JL� ([) T 7C� V � l � State - .Daytime Phone (--) 1 -2% -.15:957 Fax # c---j x`36 `71/ /1 E -mail Business Name /Type: 0 01 on t'Cl.", `tu C.0 46 L Previous Business on this site: L ,-(l -f Proposed use: i� S c`- ) -C )0,A — I V /z j /,0 12 C� ©/r / Utz I- n SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet 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 pf my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by the9M. Sikn-afure of BusY>'iess Ownei-br Agent ��✓O�� Al Print Name APPROVAL INFORMATION [ ] Approved as proposed ] Backflow device and /or current test data needed for this site. ] No physical site inspection has been done for this clearance, ] This site comp/lY/Nw� iti/t!/h I the . / jit/e � plLpf l/ a-na/s� of date, — tn A A A . Date [ VApproved with conditions Contact ACSA 977-4511, x 119. Therefore, it is not a determination of compliance with the existing site plan. L I I Building Official Date Zoning Official Date Other Official Date 1W1:1ffiiW FOR OFFICE USE ONLY ��il CLC # Fee Amount R_= Date Paid y who'? VA— _ "�'i�j receipt 11 Ck11 r By; County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fat: (434) 972 -4126 5/1 /06 Page 2 of Applicant to complete the following: Do you have one of the following? OYES ❑ NO ?fax Map and Parcel Number and or; Address of use (include unit or floor if appropriate) 2 ' YES ❑ NO 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; (-/0() () 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, Zoning Tech to Violations: ❑ YES, NO If so, List: Variance: ❑ YES NO If so, List: the ❑ YES ❑ NO Is use in LI, Hl or PDIP zoning? Engineer's Report (CER) packet. If so, give applicant a Certified F1 YES ❑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 ❑ 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 ❑ 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 If so, List: SP's: ❑ YES eNo If so, List: Square footage of Use: Permitted as: Under Section: 64y oC Supplementary regulations section: Parking formula: �( Required spaces: ❑ YES ❑ NO Items to be verified in the field: Inspector Name & Date: Notes 511106 Page 4 of S. I�j I Q - IZ3-