HomeMy WebLinkAboutCLE200700297 Legacy Document 2014-05-06ti�l�lill.Ql.1V11 iVi
Zoning Clearance
ai oning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
r
Tax map and parcel: A 0 <[e Q G Existing Zoning:
C'- 1
Parcel Owner: �UOUA LAUIS f0 Ei Grs
Parcel Address: Z.OZS Cad City tJ.1L State C, Zip ZZUZ.
(include s to of floor)
G —T a
Contact Person (Who sho uld
-
we call /write concerning this project ?):
Addre s _ (� .�G+`J< / 1� f City U. ���, State zip �Z9a
Daytime Phone ( } 75.3`J f Fax # ( Z�l �' �1(o�t E- mail
Business Name /Type:JASSGo e. G L -� +�� + < <•'� SE ✓e1��C
Previous Business rronthis site:
Proposed use: C��- C._
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 accurate to the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will
abide by m.
s Owner or Agent Date
Name
Backflow Device and /or
APPROVAL INFORMATION Contact ACSA 977 - 4.511, x 119
�] Approved as proposed [ ] Approved with conditions
[ ] Badkflow device and /or current test data needed for this site. Contact ACSA 977 -4511, x119.
[ TNo physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing site plan.
[ ] This site complies with the site plan as of this date.
Building Official _ �— Dates
Zoning Official Date IZ� �D7
Other Official Date
FOR OFFICE USE ONLY CLE #c C / � S��! Ckll i ii (c� Gi
Pee Amount $1� Date Paid 'I y who? Receipt t! u - By:
r t
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 .
Applicant to complete the following:
Do you have one of the following?
Q -�'ES ❑ 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.
: oning Tech to com
Violations:
❑ YES NO
If so, List: .
Variance:
" ❑ YES
If so, List:
NO
Mete the following:
[kYES ❑ NO
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
❑ YES aNO
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
2-YES ❑ NO
Is on public water and sewer?
❑ YES 2 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 Rr NO
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
❑ YES ❑/ NO
If so, List:
J2" 5
❑ YES ❑/ NO
If so, List:
5/1/06 Page 3 oN
Reviewer to complete the foliow
Square f otage of Use:
PeYES ❑ N���� ` ,� /
Permitted as: �(' D
Under Section:
Supplementary regulations section: %(
Parking formula: !< !"d 0 N Pot
Required spaces:
❑ YES -0�0
Items to be verified in the field:
ffr -
Inspector Name & Date:
Notes
5/1106 Page 4 of 4