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HomeMy WebLinkAboutCLE200600014 Legacy Document 2014-06-20ij Application for Zoning Zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS PARCEL INFORMATION Clearance J� OFFICE US { ONLY CLE #i Check # Date: o Receipt # Staff: Tax Map and Parcel: y (OCCO--M -GO •- O t-%% ®© Existing Zoning ©rn m f/Z Ctlt_A� Parcel Owner: _rU Parcel Address %; 11 t O`J 4 �u�' ldl City G4Wk S011 State Zip (inclu a suite or floor) --•----------------------------------•--------------- ----- -----...-•------------•--------- PRIMARY CONTACT , Who should we call /write concerning� gg this project? i `� TAGk 7 Kay Address: /66Y Kpynu✓yvj 0). City ("V' //e- State 1%4- `Z/ip, Office Phone: ( 3N) 9F 7-3939 Cell # fd25- 660° Fax # E -mail SCaO4e Q_ � )h(fn.�r • N2 ................................................................................................................ ............................... PROJECT I /Type: 1�4 T— K � �� c PLLC _ Q4 / T_ J,_J y Business Name/Type: cit. , f `,� 2e�- ,/-�i �'d'►'' Previous Business on this site: T Proposed use: 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, anew 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 knowled e. I spread the conditions of approval, and I understand them, and that I�wi�ll abide by them. Signature rinted �� I ' ^�j jam`►'. Ole .... ................. ....... ............................... ....... .................. ,, ................... ,....... ,....... I........ APPROVAL INFO TION A Approved as proposed [ ] Approved with conditions [ ] Backflow device and/or current test data needed for this site. Contact ACS7 -4511, x119., -„�- [ ] No physical site inspection has been done for this clearance. Therefore, i C e . rm 4fi7"Ice ith the existing site plan. This site complies with the site plan as of this date. B a A 5A 9 7 -4� 1 g 1 9 nt Building Official �— Date i -a k� ° G Zoning Official Date Other Official" Date ---------------------------------- - - - - -- - - - - -- � -------- - - - - -- ��-- - - - - -- 3��� -- - - -- ------------------------------------------ County of Albemarle Department oi'Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fag: (434) 972 -4126 10/14/05 Page 2 of 4 =ti Applicant to complete the following: 7l/N o you have one of the following? Tax Map and Parcel Number and or; Address of use (include unit or floor if appropriate; G O/ N 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; 0 S�t {„'[ The square footage of each room or area of use; g I Use of each room or area If using less than the entire structure, note the location within the structure. 1onine Tech to Viol ons: Y / If so, st: lariance: T j` Y y N so, List: nn the Intake to complete the following: Y/N Is LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y / Wil 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 /0 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? Y/N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Y Wil ere be any new construction or renovations? If so, obtain the proper Permit. Permit # Yh Is t is for sales of Fireworks? If so, obtain a copy of F/R permit. Permit # Pr5st: If SP's Y / Ifs , ist: 10114105 Page 3 of 4 Reviewer to complete the followings Square footage of Use: �� Permitted as: ; Df �Ceo LM7A�) Under Section: Supplementary regulations section: Parking formula: P�?bw Awe, Required spaces: Y/0 Items to be verified in the field: Inspector Name & Date: Notes fa.-7&Y -2- = Z ° 114 1%S 10114105 Page 4 of 4