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HomeMy WebLinkAboutCLE200600022 Legacy Document 2014-06-20Application for Zoning earance pp g t �ttrtN�• OFFICE USE ONLY fR Zoning Clearance = $35 CLE # z©O'fn -- 000 IR 2;� PLEASE REVIEW ALL 3 SHEETS Check # 10 5.7 Date: 1-3-7-0 0 Receipt # 5 TO -7 3 Staff: PARCEL INFORMATION p P) e. Tree. a C e lam, q u-1� Tax Map and Parcel: 7� OD " oo " C)D =- 8 t %4 Existing Zoning Parcel Owner: luck +7 U1.4t 5 c J6Eo4�4�� IlIC.Ti CS(, 'Z.1..1'ln) (01t--7ijS� 84 17) /1 Parcel Address: ZO t gtuc- aa3c�rD �dt- City �., uTre�l L t:, State V Zip ZZi7II (include suite or floor- - - -- - - -- - - - - -- - ----------- - - - -- - - - - -- -------------------- -- ----------------------- - - - - -- - ---- - - - - -- PRIMARYCONTACT � C�1��z�, -�.- �� Who should we call/write concerning this project? d � Address: PC 600 ' �-W& City "S& AO State �JG Zip Z7 (C-D T Office Phone: 36) Y T I - j"p (y Ce11 #336-Z10 - 46 Q Fax # -mail �JO�j q �eQA� ®x4 04 • Co" - --- - - - --- - - - - ----------------------------------------------------------------------------------------------------------- PROJECT INFORMAT��I�O�pN�y� //'� Business Name/Type: ulif(Jt-yw CGiZe�. � rJ—, 0t 5 44CCi�1t�1,'a15 6W_CCV► - Previous Business on this site: a6 N6' Proposed use: CUAJT lNUC. M C(44 ) C &C (0,FV C' 1UL3) il/&JAU - " ��lA(� Ti&)v C4, 1t tc3 rk7 A -ro P.0 Circle (if applicable): Fireworks / Christmas Tree SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CBRISTMAS 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 o Lor ve the ow ner's permission to use the space indicated on this application. I also certify that the information provided is true and accur to to the my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature Printed A0 ------------------------------------------------------------------------------------------------------------------------------------------------ APPROVAL INFORMATION [ICJ Approved as proposed [ ] Approved with conditions [ ] Backflow 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 determination of compliance with the existing site plan. .........._... ---- [ ] This site complies with the site plan as of this date. t Backflow Device and/or W WN. 1 �• 1 Date k Ca Date 02- o6 z666 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: Q o /N you have one of the following? Tax Map and Parcel Number and or; 1' ( t Address of use (include unit or floor if appropriate; Y / N �pFlttrJu��tt U.SC, 0,5 C LLbCtAr� o you have a Floor Plan (sketch or an architectural drawing) that includes the following, and if so please provide it with the application? (,A- -rAc 14 P) �i� The total square footage of the use and /or; 5Z 6 0 7'` The square footage of each room or area of use; SAM5* Use of eachroom or area -. SAME If using less than the entire structure, note the location within the structure. Tech to complete the Viol ns: Y / If so E t: �'C? Vat n e: Y Ifs t: Intake to complete the following: Y / Is us I, HI or PDIP zoning? If so, give applicant a Certified Engineers Report (CER) packet. VVN 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 i-,2-7-OW C ^ -�q) Y / COiP`(�uW�tW'r�t+ Sc2c,�1k5 Is p 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 10, Z%' D to Y on public water and sewer? Y IQN 0- d cA�{h d�(r -wv' ' CLOS t q Wil u be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Y Will ere be any new construction or renovations? If so, obtain the proper Permit. Permit # Y/N Is or sales of Fireworks? If so, obtain a copy of F/R permit. Permit # Proff rs: Y/P1 If so, ist: SP's: Y/ If s , L t: 10/14/05 Page 3 of 4 Reviewer to complete the following: Square footage of Use: Y/N Permitted as: Under Section: Q 5 `.Z ' 1 C1 ) --?;3' - 6-- CEO) { 3 Supplementary regulations section: Parking formula: � yeeokj Required spaces: G RCO —1 ,Lj -01h� �� �� a�e0� 2 e/ N ms to be verified in the field: Inspector Name & Date: Notes i`6la MaW At l4rzV\ WL r3 tbK) MaV1 y 10/14/05 Page 4 of 4 12- z�