HomeMy WebLinkAboutCLE200600021 Legacy Document 2014-06-20OF A�Z
Application for Zoning Clearance �®
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OFFICE USE ONLY
oning Clearance = $35 CLE # zon to --- a i
PLEASE REVIEW ALL 3 SHEETS Check # Date: 7-00
Receipt # `590%/ Staff-
PARCEL INFORMATION -1 t, OL C
�b / ®o ego � /3 D '/3 Zoning 1�'ASZ:_
Tax Map and Parcel: ,, n i� � Existing Z/o'ning 1
Parcel Owner: _�i vinvi A 6ii I I FOL.6k_i �► Si nImor (Ma60 (i�1?,b
Parcel Address: 6/ ra— City ivy` State Zip'�Z9�
dude suite or floor)____ _____________
APPLICANT INFORMATION ,
Who should we call /write concerning this project? Kdv Ckti
Address: - � &wAplry /✓ti" City 7i i State Vf1 Zip i
Office Phone: Cell #6 /7 60,4 4 I Fax # E -mail
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PRIMARY CONT ' "
Business Name /Type:
Previous Business on 1
Proposed use:
Circle (if applicable): Fireworks / Christmas Tree
SEE CONDI'T'IONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet 1)
*This Clearance will only be valid on earcel 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 e th w s permission to use the space indicated on this application. I also certify that the information provided is
true and accurate to of m ledge. I have, read the conditions of approval, and I und7tand them, and that I will abide by them.
Signature Printed Z
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AP,PRO AL I MATION
[ .4 Approved 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. Backflow Device and /or
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Building Official c Date
Zoning Official Date
Other Official Date
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County of Albemarle Department of Commu ity evelopment
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Applicant to complete the following:
0. Vou 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; ,L 2 q Sg ,
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.
, oning Tech to
Viol s:
Y/N
Ifs 1st:
Var' ce:
If / kT
Ifs , L's t:
the
Intake to complete the following:
Y/6
Is use in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
9/28/05 Page 2 of 4
If so, give applicant a Certified
N
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 r 2-7 - G (a
Y /aT
Is parcel on private well and septic?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval fro \
Health Dept. FAX DATE I (3-7 — 0 0 ` 9 -zo�a� /)
)/ N
on public water and sewer?
Y/N
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit. /ilk
Permit # /i1
Y it N
111 there be any new construction or renovations?
If so, obtain the proper Permit.
Permit # a f A c
Y <Ng
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Prof
Y/N ,
If so, 1st:
If s N
f so, L' t: f K 2_ 6 SO
S - g -6S
Reviewer to complete the following: 9/28/05 Page 3 of 4
2�Square footage of Use:
Y / N {� .(�
Permitted �s: 1�±4 1 (Jy (SQL
Under Section: 2 ' .L '�» �� •2 • �-�3�
Supplementary regulations section:`
Parking formula: CQ, I 00 S s S y 3
Required spaces:
IV U
Oc>0
Y/N
Items to be verified in the field:
Inspector Name & Date:
Notes
3/28/05 Page 4 of 4