HomeMy WebLinkAboutCLE200600040 Legacy Document 2014-06-13Application for Zoning Clearance
OFFICE USE ONLY
p Zoning Clearance = $35 CLE # zoo te ° 40
PLEASE REVIEW ALL 3 SHEETS Check # 561LI Date: a-15-04
Receipt # 5$'.5 Staff:
PARCEL INFORMATION
Tax Map and Parcel: 0-7 S 00 -00 '-0 0 - 04) o70 U Existing Zoning !!Zo M M - CTS -/i-e
Parcel
N
5 t a.l •F VD
Parcel Address:JuawA 5+a4 e r rm 141d City Ch V' LA!Le State
V
zip ?—Z% /
(include suite or floor)• -------- ------ -- ---- ---- ---- --
-------- ----
PRIMARY CONTACT
Who should we call /write concerning this project ?��fli -�
Address: �f L� i5 it„� �a "92a� RV-1 City �a ,cvi ` State ' Zip0 Z 1 qZ
t-I 3�l � iSQ _ I -P / /" c,% /5'o 1�r
Office Phone: L� ell # Fax # E -mail
.......................... _ ..... ............................... .................... V�� PROJECT INFORMATION (6 Business Name/Type: �/ �L L �, �G c t a �L� /%✓�t'/l -�
Previous Business on this site: �Cr ,�,.y �� fl r� !3 4z41- )::,
Proposed use: --) e&14e1_5' 4�1
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 acpuFait\to the best of my knowlec)ge. I have read the conditions of approval, and I understand them, and that I will abide by them.
------------------------------------------------------------------------------------------------------------------------------------ ---- - - - - --
APYROVAL INFORMATION
W Approved as proposed [ ] Approved with conditions
[ J Backflow device and/or current test data needed for this site. Contact ACSA 977- t5l. 1 11
[ ] No physical site inspection has been done for this clearance. Therefore, it is not de aireiak]?7t f�oeq�i%14 /i'tfthe isting
site plan. Curren ata eeded
[ ] This site complies with the site plan as of this date. Contact ACSA 977 -4511, x 119
WIN
Other Official
Date
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County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 10114105 Page 2 of 4
Applicant to complete the following:
O/N
Do you have one of the following?
Tax Map and Parcel Number and or;
l�
Address of use (include unit or floor if appropriate;
/
YN
o you have a Floor Plan (sketch or an architectural drawing) that
includes the following, and if so please prow' e -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 following:
Viol *
If mnt:
Vari 5L' :
Y/
If so
Intake to complete the following:
Y
Is m LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y
Wi re 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 /(D
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
) N
on public water and sewer?
Y /
Wil I—
you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
Y
Wi ere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Y/N
Is OT sal Pc - ` -s?
If so -, . f ermit.
SP's:
Y / E:
If so,
10/14/05 Page 3 of 4
Reviewer to complete the following:
Square footage of Use:
ermitted as:
Under Section: ,F�, -Ir
Supplementary regulations section: �,
Parking formula: {' AD d � *V
Required spaces:
Yfiso Ite be verified in the field:
Inspector Name & Date:
Notes
10/14/05 Page 4 of 4