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HomeMy WebLinkAboutCLE200600023 Legacy Document 2014-06-16Application for Zoning Clearance OFFICE-USE-ONLY .0 Zoning Clearance = $35 CEE # PLEASE REVIEW ALL 3 SHEETS CheclWr Date: 1 °Z7­­0(P Receipt * r, g ZZ 8 Staff LA 26 PARCEL INFORMATION ��-r" l"^ ail .e Tax Map and Parcel 66 l Z 0 - 03 _00 0 (O Existing Co Zoning ?U� -" &M Mews AQ , Parcel Owner: Ct-E; w-s € s&(motl'O,y&5 (�-3 t TW— e411 ) Parcel Address: �a ( l U y�'L� City State A— 0 Zip (include suite or floor) ________________ ____________________________ ------------------ --- - ------ ----------------- - - - - -- ----------------------------------------------- PRIMARY CONTACT ,p Who should we call/write concerning this project? Address: �� �0� quc, city 6. &W M &W State ZipZ Office Phone: L(0 l b 'S6 (� Cell #.� -Z(o 0 Fax J-Y-AT 6` ,6(9 E -mail &`bJ Ve �® AC)t- - CiO'�'1 - -------------- - ------------------------ -------------------------------------------------------------------------------------------------------- PROJECT INFO ION Business Name/Type: OO6L.4"105 �i� Yu4w(, — G +l e�►0q�C C Z( Previous Business on this site: aW6_ Proposed use: C ArC(NU.( A1,5 Q+(WCo0 C(�-C!,'e� - -M6 Um-ti 116 oT( t2. ZG AI(�tn� /-IiAA�iL� 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 ave the owner's permission to use the space indicated on this application. I also certify that the information provided is true and accurate the best f my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature Printed A6A 62- ------------------------------------------------------------------------------------------------------------------------------------------------ PROVAL INFORMATION [ Approved as proposed [ ] Approved with conditions [ ] Backflow device and/or current test data needed for this site. [ ] No physical site inspection has been done for this clearance. site plan. [ ] This site complies with the site plan as of this date. Contact ACSA 977 -4511, x119. Therefore, it is not a determination of compliance with the existing Barttiow Device and/or Building Official. Date I 1 o E Zoning Official Date aZ 67 207% Other Official Date ------------------------------------------------------------------------------------------------------------------------------------------------- County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 10/14/05 Page 2 of 4 =-Applicant to complete the following: ©/N Do you have one of the following? SCftr AOPt LC A 11c fJ Tax Map and Parcel Number and or; ' I t Address of use (include unit or floor if appropriate; �/ N 5AA5 -COA PI-kiJ As curd t" o you have a Floor Plan (sketch or an architectural drawing) that includes the following, and if so please provide it with the application? (k r-r,4wep) v The total square footage of the use and/or; SO 00 The square footage of each room or area of use; 5rt AA, 6' Use of each room or area :51k -AC; If using less than the entire structure, note the location within the structure. Tech to complete the Y If Y/ If sc Y If Y If Intake to complete the following: Y/N Is u LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. YIN ill 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 e6mx 7(b -a� o DNI 8¢Z -7) Is parcel on private well and septic? If so, give applicant a Health Department form. Zoning review can not begin until we rec ive approval from Health Dept. FAX DATE • =T • /N on public water and sewer? I N 6O- qO SAYS Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. G-C)I00- Permit # F 0 ��' J 1 �£ i� "(b �QL{GI�NT s; Will there be any new construction o l r renovations? If so, obtain the proper Permit. Permit # Y Is this for sales of Fireworks? If so, obtain a copy of FIR permit. Permit # 10114105 Page 3 of 4 Reviewer to complete the following: Square footage of Use: , > 6 C) C) Y / N Permitted as: JIA Under Section: Supplementary regulations section: Parking formula: Required spaces: Y/N Items to be verified in the field: -pe - ajA4�oq e.. / ickU P aw► d Da) 6 r Inspector Name & Date: Notes Vj AAAhl to ftDW PaAj -gyp - ►� -tom kAWe ? 10/14/05 Page 4 of 4