HomeMy WebLinkAboutCLE200700246 Legacy Document 2014-04-28X 1
Zoning Clearance
❑ Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
Tax snap and parcel: 64 _'; fS I — 0 b '°OCR — d d 100 V _ Existing Zoning: LP G27AI-111
Parcel Owner: 14, I-e j
Parcel Address -.,23 1 Sei�9►teo1-� iy9�► -c Svf k �o City C�i�riyia �5 �(r' %l-e State GI lip �® /
(IIICItIdL' SUitL' OI' I100r')7,0/9FkVj'
4
Contact Person .(Who should we call /write concerning this project ?): �/6�Y1 `�/ �7.�� d11 d�1 /'�
Address t(d Boc City nj 4d;SY3 Y State v� Zip o2�7�r%
.Daytime P110110 .6. 923- JO LS'/ Fax # (_�y�i %%T^ JO Y
Business Name /Type: K�iA/ / �`Si1 / ul��`1 %` iJ✓'rt' DL
Previous Business on this site: J?-e fig
Proposed use: �i'�� J FU/ 111 vv-e
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 of my knowledge. I have read the conditions of approval, and I understand them, and that I will
abide b them.
y
/O /W a 7
Signature of Business Owner or Agent Date
Print Name
AP/PkOVAL INFORMATION
[ Approved as proposed
[ ] Approved with conditions [o.e-mi*hrtMie-TtMTu1g ckfloW Device and /or
Current Test Data Needed
[ ] Backflow device and /or current test data needed for this site. Contact ACSA 977 -4511, x 119. act ACSA 977-4511, % 119
[ ] No physical site inspection has been done for this clearance, Therefore, it is not a determination orcomplia site pan.
[ ] This site complies with the site plan as of this date.
Building Official
Date_io � '0-1
Zoning Official Date 0
Other Official Date
FOR OFFICE USE ONLY Y CL a6 �'da%'1 p Ck# / %��
Fee Amount S 35- �� Dale Paid 10- 4 -W D who: �1 Recei tit BY �
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434).296-5832 Fax: (434) 972 -4126 5/1/06 Page 2 of
, Applicant to complete the following:
Do you Dave one of the following?
-' YES ❑ NO
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate)
'R YES ❑ NO
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; 71ocsj Fr
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
a�wa.u.
YES ❑ NO
the
If so, Li o
17-a7 /, I r---e-4- .
Variance:
❑YES ONO
If so, List:
1111MICe LU CUiill IMV, LIM 1U11UW111g.
❑ YES [V/NO
Is use in LI, Hl or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
❑ YES 0
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 Pf 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 0 NO
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
❑ YES 2 NO
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
❑ YES 0
If w. List:
Y SP'
YES ❑ NO
If so�Iril fl ' Ct'/Sd�4
�aSquare footage of Use:
i e
S ❑ NO r
Permitted as:��
Under Section:
Supplementary regulations section: `I Ot
Parking formula: ObO
Required spaces: _ ( I
❑ YES ❑ NO
items to be verified in the field:
Inspector Name & Date:
Notes
511106 Page 4 oN
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