HomeMy WebLinkAboutCLE200600024 Legacy Document 2014-06-16s
-A: plication for Zoning Clearance
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� OFFICE USE ONLY
R�&ning Clearance = $35 CLE # 77_00&— 0 0 0 q
PLEASE REVIEW ALL 3 SHEETS Check# Date: /— 777 --O(p
Receipt # Z C7 Staff.
PARCEL INFORMATION
Tax Map and Parcel: o S& /4 a —0 ex - 033 60 Existing Zoning
Parcel Owner:
07
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Parcel Address: 56-74 ki-Lu ity� —�r� � � t State � �Z g
include suite or floor Q" Z'
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APPLICANTINFORMATION -- - - -- ---------------------------------------------------------
Who should we call/write concerning this project?
Address:—,.
.. C..' C. 9 ^L. t'� %I City State �,� '�' Zip 2 2';&, ,
Office Phone: `°` -; �'� �, ; j�' i Cell # u C %,i —. ;� S �s�Fax # E -mail
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PRIMARY CONTACT � �( - g ------------------------ �------------------------------ - - - - --
Business Name/Type: : -a ^v ?� C In t- !c "�t�c d� k; rld I 7'1,
Previous Business on this site:
Proposed use: I e!` � 1 t i 1� 1 L 5 r i " -'1 7 r a'� f _. +` C_ /1' �h ¢j 1 �j..: `.� ,
�s
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
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AP ROVAL INFORMATION-- - - - - -- -------------------------------------------------------------------------
V pproved as proposed [ ] Approved with conditions
[ ] 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. y
I3ackffow Device and/or,
Curren
Contact
Building Official �.,A Date
Zoning Official �� `�jijf✓L� Date �l A
V j
Other Official ?te
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C unty of Al be le Department o Co unity Dev opment
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) °972 -4126
Appli -eaint to complete the following:
�Yc N ,
` Do you have one of the following?
Tax Map and Parcel Number and or,
Address of'use (include ' ni or floor if approtpriat {e;
Do you have a Floor Plan (sketch or•9n architectural drawing) that
includes the following, and if so please provide it with the
application? s� ►�1 -,
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.
Intake to complete the following:
Y /�
Is use in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y ID
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
WAN.
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? L/
Y// N
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
YIN
Will there be any new construction or renovations?
If so, obtain the proper Permit. a r ! Veo LA-3 Q.4-d,
Permit #
Is /'r�'f
Is th' or sales of Fireworks?
If so, obtain a copy of FIR permit.
Permit #
4,V1
Zoning Tech to complete the following: A-) 6 S� / L) PASS Q2�( / LA1 PO4
—A n /✓ , C
Y
If
Vari ce:
Y/N
Ifs 'st:
Pro
YIN
Ifs , st:
Y/
If sc
Reviewer to complete the following: q /
Square ,footage of Use: e C' i %' / t � ctw
Y'/ N
Permitted 4-h
Under Section:
Supplementary regulations �Y section:
A.
Parking formula:
/V/ ,
r to
Required spaces: /V .J ;L'tt C- ' n ag/
Y/N
ev
Inspector Name & Date:
Notes
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