HomeMy WebLinkAboutCLE200600034 Legacy Document 2014-06-13Application for Zoning Clearance
['Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
PARCEL INFORMATION
. OFFICE USE
CLE #
Check # (y tip 1 Date: —o
Receipt # Staff: go
GU10_1_ �
Tax Map and Parcel: - 2_6
Parcel Owner:
Existing Zoning a0 1-n
��RGINIP
Parcel Address: I 1 §0 iii CAN"6 V.,8 V-� , City C ,—,A �ViAtate U Zip
- - (include suite -or fl oor).RV_V� 100_( ------------------------------------
----------------- ----------------------------------------
APPLICANT INFORMATION
Who should we call/write con erning this project?
r G�1 G
P a (ba�0
Address : j.�- S- H---'" _ City _ Lx) C-\4\ State y A Zip D_a_Qfy__ 7
Office Phone: (may) � O 19 '7 Cell A3q -a4d-Q1% Fax # A55 -�63 1 E -mail ► C. � Rk (1 I+-1 A n 1 Egr4
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PRIMARY CONTACT C n
Business Name/Type: _yl�t_c Z 1 �6/n�
Previous Business on this site: y e— r l__-O U 2
Proposed use: C�S-%C_e_
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 ormove 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 cc, C
g
- - -- -------------------------------------------------------------------------------------------------------
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APVROVAL INFORMATION
Approved as proposed [ ] Approved with conditions
[ ] No physical site inspection has been done for this clearance. Therefore, it is t atipgpaygille - Current Test Data Needed
W* h the existing
site plan.
[
This site complies with the site plan as of this date. Contact ACSA 971-4511, x 119
Building, Official Date 0 6
y
Zoning Official Date DZ z.3
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
Applicant to complete the following:
Y
Do you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
Y/N
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.
S'a�
�Ud
Tech to complete the
Vio o s:
Y
Ifs t: / N
var e:
Y/N
If so, t:
Intake to complete the following:
Y
Is use m LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y N�
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
Y N
Is p rcel 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 .
Will-you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
Y
Where e be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Y
Is or sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Frof
Y/
Ifs , t:
Y 's N
so, List: S P -' I I g _� n
•f
Reviewer to eompfete the following:
Square footage of Use: Lila Q 0
T
Y`/ N
Permitted as: oJrn , n 16 rbl-e6A j oF.AZe s
Under Section:
Supplementary regulations section:'
Parking formula: 006
Required spaces:
Y /0
Items to be verified in the field:
Inspector Name & Date:
Notes
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