HomeMy WebLinkAboutCLE200600047 Legacy Document 2014-06-13AP l cati on f ®r Zoning Clearance
OFFICE USE ONLY y
El Zoning Clearance = S35 CLE # (�
PLEASE REVIEW ALL 3 SHEETS Check # 60 " 1D Date:
Receipt #_ 6 Staff:
PARCEL INFORMATION ,, ``
Tax Map and Parcel: Jay)- CiCS --�CL),a Existing Zoning //c—
Parcel
Parcel Address: 9yo /� /�A& City State (✓'Q Zip "i11
(include suite r floor) __-
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APPLICANT INFORMATION - -- - - - -- --
Who should we call /write concerning this project?
Address u ---A ` 1�l° r l City _� /1 � � �� State ✓ A Zip
Office Phone: 61q) Cell # (J! � �J -•Fax # I J._'�65,_ - E -mail
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PRIMARY CONTA
Business Name /Type:
Previous Business on this site: ,
Proposed use: 1, -1 0✓ Ili/ �' i / , C
Circle (if applicable): Fireworks / Christmas Tree
SITE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet 1)
*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 II understand them, and that I will abide by them.
Signature ..e._.,.... -.A -�` °. Printed �li✓�`� l a - - .� /� ��'. 0 ,,1 �`i Z'L - i`�
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A ROVA , INFORMATION
�pproved as proposed [ ] Approved with conditions
[ ] No physical site inspection has been done for this clearance. Therefore, it is not a determination of complianc with the existing
site plan.
[ ] This site complies with the site plan as of this date. r-- ...,...�
Building Official Date
Zoning Official Date
r
Other Official Date
Coun F_--------------------- - - -- - -- -d -- - -- - - --------------------- -----------------
4AIbemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
`Applcgnt to complete the following:
Y N14
DoYoulhave one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
/N
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.
Y/
If sc
Var
Y/
If sc
10
Tech to complete the followin
nee:
Y
If
�i =.oiw ra�c /- Vl 4
Intake to complete the following:
Y /
Is us �
LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y 4 N
Wil th e 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
Y/N
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
Y/N
Is on public water and sewer?
Y/N
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
Y/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Y/N
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
SP's
Y/
If so L st:
Reviewer to complete the following:
8quare't'botage of Use:
Y VN "'
eermitted as: t r nmo Y-v
Under Section: Supplementary regulations regulations section:
Parking formula: bz,�
Required spaces: 44t� h674—
Y
Ite /� s to be verified in the field:
Inspector Name & Date:
Notes
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