HomeMy WebLinkAboutCLE200600045 Legacy Document 2014-06-13Application for Zoning
/Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
Clearance
OFFICE USE ONLY
CLE # Z,00(1
Check #
Receipt # CJ-
PARCEL INFORMATION
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Tax Map and Parcel: 013 WO 00 ]010 ✓ 0,37/9 0 Existing Zoning J4 LA) � �Q � Y-KI
Parcel Owner: �(_,.� %�i L LC
Parcel Address: 34 `- Q S in IIyo Je city N- V d�_ State VOL-, Zip ZZ9 /
(include suite or floor) -------------------------------------------------------------------------
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PRIMARY CONTACT
Who should we call /write concerning this project? j yw ! Ic
Address: 2 6 1, E L3 H Y a vJ 1 c TJ . City (. i r'A^r) u"1'? e-) VI) e State Zip 2 2
Office Phone: • 3 1 �i4 •-43 &c1 Cell # -2-27-63Z4- Fax # E -mail
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PROJECT INFORMATION i
Business Name/Type: J e y se,/ ��� + K e 'S S,-\ 7
Previous Business on this site: Te Y � e
Proposed use: S Is r) �! 1,� ,ate 1, rn CA
J
Circle (if applicable): Fireworks / Christmas Tree
SEE 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 I understand them, and that I will abide by them.
Signature `� Printed P�—K-G-,V
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k 1] ROVAL INFORMATION N Approved as proposed [ ] Approved with conditions
ackflow 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 determi 'a existing
site plan. Backtlow Duce and/or
[ ] This site complies with the site plan as of this date. �Itl`1lYnt`�� �$� Needed
rv. _ __ . y.._ .
Building Official Date /
Zoning Official Date
Other Official Date
------------------- - - - - -- -- - - �_e_p�ritm_Uefipt - - - Vop�Jm_e_n__t --------------------------
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401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 10114105 Page 2 of 4
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A;pplicant to complete the. following:
�CY N
Do you have one of the following?
Tax Map and Parcel Numb end -or; ✓
Address of use Firms u el a unit or floor if appropriate
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.
Zoning Tech to complete the fo
Violns: f
If so,Zist.
Ilk rf-V
riance:
Y/N
f Wt:
Intake to complete the fo.11oWing:
Is/
Is u I, HI or PDIP zoning ?. If so, give applicant a Certified
Engineer's Report (CER) packet'
Will here be food preparation? �(!i �'
If so, give applicant a Health Depa tment form.
Zoning review cannot begin until we receive approval from
Health Dept. FAX DATE
C QA Q If�P/h>'
Is p 6np private well and septic? -
If so, give applicant a Health Department form.
Z ning review can not begin until we receive approval from ,
ealth Dept. FAX DATE
o u lic water and sewe ?
Y �N
Wi { ou ) be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
ALtWre be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Is nN
Is t ' r sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
YEN
SO, List:
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10114105 Page 3 of 4
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