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HomeMy WebLinkAboutCLE200700301 Legacy Document 2014-05-16t11J�l11l.Q1.1V11 AV1 e'er': ^. '� 1 � r Zoning Clearance `IYItCIN�� 12/51*�Oning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS Tax niap and Existing Zoning: Parcel Owner: Parcel Address: 000 z_ III s� terra' / City. oTT�tJ -� State (/� , Zip S (include suite or floor) % % /' Contact Person (Who should we call /write concerning this project ?): ��/� /.`S "[./ -/��cS Address 3, S' sL� f ©, a ��G� - City �S< >, M--` State (/G ' Zip Daytime Phone LW 9?S -/- 06'ffEax # (V3r/) '8-3//—,3/'/0 E -mail �4%• / c�/✓�X �` �e Business Name /Type: \��.-.01 Previous Business on this site: 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 m. 1�iature of BusinesOwner or Agent Date r, ` Tint Name APPROVAL INFORMATION [ ] Approved as proposed proved with conditions [ ] B c ow device and /or current test data needed for this site. Contact ACSA 977 -4511, x 119. [ o ph t i 11 site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing site plan. [?,. r ith the siterplan as of this date., __ - n /� _— - / _ _ A Building Official Date Zoning Official Date Other Official Date FOR OFFICE USE ONLY CLE# 0 /� (% t Pee Amount 9 ) ,// V Date Paid �!�y who? Receipt # wOjr(l Ckl! By: 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 ora Applidant to complete the following: Do you have one of the following? 'ES ❑ NO Tax Map and Parcel Number and or; Address of use (include unit or floor if appropriate) ❑ YES N- 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. yid C ,oning Tech t Violations: ❑ YES NO If so, List: Variance: ❑ YES If so, List: I�C�7 ajD lete the followin ❑ YES [eNO Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) 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 N"'YES ❑ NO Is parcel on private well and septic? If so, give applicant a Health Department form. Zoning review can not begin un i e eceive approval from Health Dept. FAX DATE 7 ❑ YES �2'NO Is on public water and sewer? ❑ YES XNO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑YES �NO Will there j e any new construction or renovations? If so, obtain the proper Permit. Permit # ❑ YES r®'NO Is this for sales of Fireworks? If so, obtain a copy of F/R permit. Permit # Proffers: ❑ YES NO If so, List: SP's: ❑ YES If so, List: Keel 5/1/0( Page 3 a r 4 Reviewe -to complete the foil , ((f�L nt Square footage of Use: ``'��{ [YES ❑ NO �Permitted as: V16A Under Section: 6 A Supplementary regulations section: Ck Parking formula: Required spaces/ ❑ YES NO Inspector Name & Date: Notes 5/1/06 Page 4 of 4