HomeMy WebLinkAboutCLE200700295 Legacy Document 2014-05-06Application for
Zoning Clearance
1�noning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
Tax map and parcel: /. 7iA >e- "A W 7 / R�+'W -G1651—� j7 Existing
Parcel Owner:
Parcel Address: 2 d2�S Low of ZD City
(include suite or floor)
ing: C'
Zip
Contact Person (Who should we call /write concerning this project ?):
Address JP16 City S "7rS 1114 -t --f State V-9 Zip
Daytime Phone Fax # (` E -mail GC./ 1b CT�i.rtiy Gd 11n
Business Name /Type:
Previous Business on this site: A ��'r�L� �1 A-57- IV4'I✓K
Proposed use:
r
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 them.
- 2ac12_ 1-1 Zia l
ignature of usil es caner or Ag nt Date
z,
Print Name
APPROVAL INFORMATION A
4,A proved as proposed [ ]'Approved with conditions cl(fow device and /or current test data needed for this site. Contact ACSA 977 -4511, x119.
[ �physical site inspection has been done for this clearance. Therefore, it is not a determination omplia ce with 'he existing site plan.
,T i�sit complies with he site lave as of this � n ��� OL
Building Official Date Ell o V
Zoning Official Date 41 ( /CN&
Other Official �av Date 1
FOR OFFICE
LY CLE # 260? 00 O-C�
`Dte Paid � �� By wo? jet Rece ipt # Pee Amount $ 7 C Ck# 190
By: 'V 1
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 4
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
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.
ZoninLy Tech to co
Violations: f
❑ YES 0 NO
If so, List:
Variance:
❑ YES 0' NO
If so, List:
the
IntaKe to cumplutc Litt ivitvrriair'.
❑ YES p�' NO
Is use in LI, I or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
❑ YES NO
Will there od preparation?
If so, give pplicant a Health Department form.
Zoning review can not begin unt 1 we eceive approval from
Health Dept. FAX DATE 0
LJ' YES ❑ N-
Is parcel on rivate we 1 n se t'c?
If so, give app`I' a ealth Department form.
Zoning review can not begin until we receive approval from
Health Dept. FAX DATE
❑ YES NO
Is on public ater and sewer-?
YES F-1 NO
i 1 you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
YES ❑ NO
of l 1 there be any new construction or renovations? `
If so, obta' therrproper
Permit it l
❑ YES 7 NO
Is this for sa'le's of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
❑ YES NO
If so, List:
SP7
CI YES ❑ NO
If so, List:
5/1/06 Page 3 of
.i
Reviewer to complete the f wi ���
Square footage of Use:
YES ❑ N���
Permitted as:
Under Section:
Supplementary regulation section: + 1
Parking formula:
Required spaces: UI
❑ YES ❑ NO
Items to be verified in the field:
Inspector Name & Date:
Notes
X Yy�a�
5/1/06 Page 4 of 4