HomeMy WebLinkAboutCLE200700306 Legacy Document 2014-05-161 vFFl1l aLll!11. IV1
Zoning Clearance
❑ Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
t'UtCIN \^
Tax map and parcel: �;/tl, f PAa 02 91C Existing Zoning: ,€o- Aral A6/e,S
Parcel Owner: R/Z - /4 L
Parcel Address: �19yZ 121do0uz W ,'-*d City A-C'X e/ /e %L State
(include suite or floor)
Zip ZZfy7
Contact Person (Who should we call /write concerning this project ?): 1 -y"A4 '5 -<e, /%
Address--5-60 1z111K4 va Coaee City State a,* Zip Z?-90Z
Daytime Phone 4�3 0 Fax # E -mail
GQ YH-
Business Name /Type: /36 yd
Previous Business on this site:,/Ci
Proposed use: C / %G�k- i/� lil.�JVs���
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.
Signature of Business Owner or Agent Date
fff�r�6fS .SST
Print Name
APPROVAL INFORMATION
Approved as proposed [ ] Approved with conditions
A Baci flow 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.
[ ] This site complies with the site plan as of this date.
Building Official c
Zoning Official
Other Official
Date L -Z, Z
Date v �'
Date
FOR OFFICE USE ONLY CLE N atx�'�bb�,bC qZj .
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Pee Amount $ 3S,CO Date Paid 1� -� 5i By who a7 Receipt 11 6 �S CH / I By: (p� 7
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 ot'4
Applicant to complete the following:
Do you have one of the following?
U?'�'ES ❑ NO
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate)
RYES ❑ 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.
/1 2. ft q sy, fr
Tech to
the
Violations:
F YES ❑ NO
, List: 6 - Z / L g6,gl
6 ,
Variance:
FYES ❑ NO
so, List:
❑ YES NO
Is use in L , HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
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
Health Dept, FAX DATE _ &I ►—_'
❑ YES Z NO
Is on publ c water and sewer?
❑ YES ❑ NO
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
❑ YES [�K0
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
❑ YES JKN0
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
❑ YES 0 NO
If so, List:
SPX,
JZ YES ❑ NO
If so, List:
7� y —Vain
5/1/06 Page 3 of
Reviewer to complete the following:
square footage of Use: /Z � q
❑ yFJ/ as: ❑ NO
iJ
Permitt d G/NVi`Cn/tve�Y"
Under Section:
Supplementary regulations section:
Parking formula: 4j6 J�
Required spaces:
❑ YESZI NO
Items to be verified in the field:
Inspector Name & Date:
Notes
5/1/06 Page 4 or