HomeMy WebLinkAboutCLE200600016 Legacy Document 2014-06-20Application for Zoning
/Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
PARCEL INFORMATION
Clearance I �L
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OFFICE USE ONLY
CLE # 200 & -
Check # o 5 a -5 _
Receipt # 5 $0,5 g- Staff: hQ
Q tV IV e. Fi + 7—q-0-4 CLV_C (-,
26 -00
Tax Map and Parcel: ] Ltd bL, ] o o -- CD I —6C, W64xisting Zoning (700-7 In ��'12
Parcel Owner: of �e M ) ce ✓
Parcel Address: t1z 1,Q 24 c l Prc). Cityn h) J tj) State Zipt�d�JG
(include suite_or floor)_ -
------------------- - - - - -- -------------------------------------------------------------------------------------
APPLICANT INFORMATION --too-) - _
Who should we call /write concerning this project? (I— j / Z0 p,
Address LQ ( Qp_\ 08 Zco - City ch I ✓i IC9 State V +q-
Office Phone: `i o
l o�� Cell # 4G&-4]gto Fax # "5-L[140 E -mail
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PRIMARY CONTACtt
Business Name/Type: ra _J)P c�D yy;c
Previous Business on this site:
Proposed use:
1 Y1 ]off Y,
Circle (if applicable): Fireworks / Christmas Tree
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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 ce 'fy 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 ac ur a to the st of my Icy wledge. have read the conditions of approval, and I understand them, and that I will abide by them.
Signature n Printed A-nh ce Q_1 ]
L
A PPRO - V A L - - I N__ - F__ O -- - - --- - ---I -O --- N ----------------------------------------------------------------------
--------------------------------
RMAT
[�J 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.
Building Official
Official Zoning �% Get.
Other Official
Date
Date 0Z/ Zz I-;:
Date
R
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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:
Do you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
@/N
o 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.
`zb
Zoning Tech to complete the
Viol I'ons:
Y
If so, ist: A bkTw
Vari ce:
Y/
If so, ist:
N,Zqfa�L.
7 11-aivD rage � of 4
Intake to complete the following:
Y (0 Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y
Wi ere 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 /LJ
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 Or
'N
on public water and sewer?
Yom/ N
-dill you be putting up a new sign of any kind? If so, obtain
proper Sign permit. e
Permit# iaN /
Y /
Wil ere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Y
Is thi or sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Prof s:
Y/N
If so, st:
SP's
Y /
If so,
Rev ewer to complete the following:
,,Square footage of Use:
IMIF
Permitted as: (illo-mo6 le r f fa (% ►��,�.Yt { 1' 2k6(uj! vtG1 �(JOt y s�p
Under Section: ' a Cb )_22-
cJ
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Supplementary regulations section:
Parking formula: OM P 10 P 6 (2) ll �acu Kv- .Pet.( 5>✓rl ✓(22 S �I
Required spaces:
Y/N
Items to be verified in the field:
Inspector Name & Date:
Notes
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