HomeMy WebLinkAboutCLE200600011 Legacy Document 2014-06-20Application for Zoning Clearance
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OFFICE USE ONLY
❑ Zoning Clearance = $35 CLE #
PLEASE REVIEW ALL 3 SHEETS Check # ! Date:
Rece' t # Staff:
PARCEL INFORMATION �J -0 Co
Tax Map and Parcel: 3� r�� ,- Existing Zoning i4c
Parcel Owner:
Parcel Address:
City
State
Zip
(include suite or floor)
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APPLICAN T INFORMATION f
Who should we call /write concerning this project? T)Q /T no e1 G F? rerv_ o
Address :
Office Phone: (. ) gZ 11 a —`TRSS
cS t.;tl tc�gCity
State �) Zip 22.x«
# 4o9 — CL, L+ Fax # R74 _ C(t , E -mail
CON'1
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PRIMARY CONTACT L
Business Name/Type: cD �Ci C 1 r11 C. I e BLS- F-oM l ckl r-o r tC
e-
Previous Business on this site:
'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, a new 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 knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed- r � h G � ,
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PPROVAL INFORMATION
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. I/
[ ] This site complies with the site plan as of this date.
Buildinj
Zoning
Date ad --I I 0 (,
Date �0�'0666
T
Other Official Date
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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:
�
/ N
Do you have one of the following?
Tax Map and Parcel Number and or;
Addre� ss of use (include unit or floor if appropriate;
0o / 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;
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.
foo'7,7
mC s5CL��,- 200f
l�6-.� NQ I, I, Y" �
Tech to complete the
Viol • e s:
Y /
If o, L'
variance:
Y /N4
If so t:
Intake to complete the following:
Is /�Is u LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y /
Wi t re 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/
Is p 61 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/
Willa be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit # VJ-T It/ R'LGL UAAr ��
Y/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Y/N
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Y) / N
f so, List:
� N
so, List: q n
..SP- iq t i �3
nevIewer w euui ICLe me twiowin
Square footage of Use:
Y/N
Permitted as: Ge�i2l6hJ� l M�
Under Section: off'' 23
Supplementary regulations section:
Parking formula: S,Q, //Q.��jZ?.✓3U
Required spaces:
Y /o
Items to be verified in the field:
Inspector Name & Date:
Notes
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