HomeMy WebLinkAboutCLE200700248 Legacy Document 2014-04-281 1
Zoning Clearance
❑ Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
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I pK;IN�F
Tax map and parcel: 0 0 - 0 0 ° 00 Zo 0 Existing Zoning:
Pareel Owner: Q ! Q 1 I �J-i- �i1� .t(1�'L�1ii/ (�7 Y� !,✓L�
Parcel Address: JOA 0 P, 5'T 11 1,D D City ` �O GTF/S�i W�� State _lip
(include suite or floor) i
Contact Persow(Who should we call /write Coucerning this project ?): IJos-i ht2v no n v�
Address �3 We s+ Q'., 0 k City Chc,do y�s -'4 State iii} Zip -A-4 10
Daytime.PhoneLq3�4 J-13-56'10 'Fax #( -(3'l) X11- -14`1% E -mail
Business Name /Type:
Previous Business on this site: SSG C_O e5
Proposed use:
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 by t
Sigature of Business Owner or Agent Date
I&S C ht�urrlCcrn
Print Name
AP OVAL INFORMATION
( Approved as proposed [ ] Approved with conditions
Backfflotiv Device and/or -
[ ] Backilow device and /or current test data needed for this site. Contact ACSA 977 -4511, x 119. Current Test Data Needed
[ ] No physical site inspection has been clone for this clearance, Therefore, it is not a determination of complian l x 119
[ ] This site complies with the site plan as of this date.
Building Official
Zoning Official
Other Official
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FOR OFFICE USE ONLY CLE # d —CQ
Fec Amount $ Dale Paid 10 -'f-09 By who? &a lw e^-- A Receipt 11 Z79�nO Ck# CCI�5k- By: V75
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 oN
App I14cant 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
Do you have a Floor Plan (sketch or au architectural drawing) that
includes the following, and if so please provide it with the
application?
Tile 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.
Zoning Tech to
Violations:��
❑ YES L3 N
If so, List:
Variance:
❑ YES ONO
If so, List:
the
inLaKe LU (:01I1P1eLe Lilo 1u11vYY111g:
❑ YES NO
Is use in LI, II or PDIP zoning? If so, give applicant a Ce
Engineer's Report ( ER) packet.
❑ 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
Healtl Dept, FAX DATE
YES ❑ NO
Is on public 7NO t sewer?
❑ YES
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
❑ YES ❑INNO
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
❑ YES 0
Is this for sa es of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
❑ YES NO
If so, List:
SP's:
❑ YES [V NO
If so, List:
rtified
Squarr e'foo age 4 Use:
Es E
Permitted as:
Under Sectioi
Supplementar
Parking formula: 1/1 a6
Required spaces: �p/�nn
❑ YES ❑ NO
items to be verified in the field:
511106 Page 4 oN
3 (D3�'� .
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EXHIBIT A
Showing Premises
Not to Scale
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