HomeMy WebLinkAboutCLE200700299 Legacy Document 2014-05-06tiVFal« aiaval< Itvi
Zoning Clearance
❑ Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
Tax map and parcel: �lt�0 °` l!'�Sd Existing Zoning: (+ I
e/ �
Parcel Owner: �Q
Parcel Address: �J �' (%yvR� / C�ity�/�-�tLe3V� `State
(include suite or floor)
VA
Contact Person (Who should we call /write concerning this project ?): IDl //G (e%% %%r'C --40 `
Address % %� �� ! �`��-�� Z —,XJ City (f AX L/_6�I ?S�! lIKt State V ' Zip
Daytime Phone 7 Px € /��fT E -mails l r')x)�i1� --
11 cz 6 v��►
Business Name /Type:
IT010-0
Previous Business on this site:
Proposed use: k % T-1 L-- "LS 'C
Cl�)
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 th
Sign tune of Business Owner or Agent Date
Print Name
APPROVAL INFORMATION
[ ] Approved as proposed
[1/]"Approved with conditions
] Backflow device and /or current test data needed for this site. Contact ACSA 977 -4511, x119.
] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing site plan.
] Thi ite complie with the s 'e plan a of this dat
Building Official Date z- o-1
Zoning Official Date Z,41 (d 7_
Other Official Date
FOR OFFICE USE ONLY CLE # a6676 -OR4#
Pee Amount $ %- (Y/ Date Paid 1:2-1 d'- Zy who? /--, I-,!C Receipt ll 6_TS Ck# GN lam' By: V 75
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434).972 -4126 5 /l /06 Page 2 ol•4
Appli6nt 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 hav 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.
Tech to
Violations:
❑ YES NO
If so, List:
Variance:
❑ YES NO
If so, List:
the
❑ YES NO
Is use in LI, II or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
❑ YES R 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 pk ivate 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 ater 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 b any new construction or renovations?
If so, obtain the proper Permit.
Permit #
❑ YES NO
Is this for sal s of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
❑ YES NO
If so, List:
SP's: �
❑ YES
If so, List:
5/1/06 Page 3 of 4
Revievder to complete the foll v ng:
;ell-/Inua, eotage of Use: YES NO
itted as;
Under Section:
Supplementary regulations section: h101
Parking formula: `'li1 OL
Required spaces:
❑❑ YES ❑ NO
Items to be verified in the field:
Inspector Name & Date:
Notes
5/1/06 Page 4 of