HomeMy WebLinkAboutCLE200600010 Legacy Document 2014-06-20. _.ppliccaatfo 444 ZQ n Fleay a nce
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OFFICE USE ONLY
❑ Zoning Clearance = $35 -CLE # _ 0Q
PLEASE REVIEW ALL 3 HEE- T -s�' Check# _a5_ a3 Date: 1-20-04;
Re t # 1 0 SU Staff: &W
PARCEL INFORMATION /j F - C Lz5ya0�-iO
Tax Ma and Parcel: ,�� �% ,/ J J
Map Existing Zoning C�hfm�•e/� .i/t� v��� w
Parcel Owner: ]. h C6 E —WC,
Parcel Address: Na n Yl h lio,KC�I City &ck ln&,�I,IiIItState VA Zip a2
.............(include suite_or floor)
- - -------------------------------------------------------------------------------------------
APPLICANT INFORMATION
Who should we call /write concerning this project? U 'i 1 I,1 CI m c,
Address : qo(� �• s• 2,2 1)12y1u, City
Office Phone: _ Cell #
State zip�9 03
Fax # E -mail y V't ( (poi Inn �e n , n3
- P -- - R- I- - -- -- R-----Y -C --- ONT------ ACT -C__T----------------------------------------------------------------------------------------------------------------
MA 1
Business Name /Type: C5
Previous Business on this site:
Proposed use: aX11�n', ,—,�rCA1tU2 0 NlCeS
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 he best of ut� kn ledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
. . �' 11
Signature Printed���y
----------------- - - - - -- -- - - - - -- --- - - - - --
AIPROVAL INFOB
Approved as proposed
[ ] No physical site inspection
site plan.
[ ] This site complies wit�,,the
[Q!ick& w Mvlce and/or
Cumat Test Data Needed
contact At 977.4511. x 1
site Man as of this date.
Approved with conditions, �C p
'efore, it is not a determin io o 1
�-- zu
Building Official Date L
AA
Zoning Official / %I'_% Vii? �i -�� Date • r . ,
Other Official Date
------------------------- - - - - -- - - - - -`� -- -- ment -p-, -- -- - - -- -- - - - - -- -- -- - - -- -- -- -
County of Albemarle Depart of mmunity Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
-tpplicant to complete the following:
I5 N
o you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
Q/ 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;
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.
Tech to complete the
Viola ions:
Y
/
If so, ist:
9/28/05 Page 2 of 4
Intake to complete the following:
Y
Is us LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y /
Will t 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 /NN
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
YN .
on public water and sewer?
Y /0
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
�
/ N
i �
ll there be any new construction or renovations?
If so, obtain the proper Permit. , r,
15-g vp
Is /
Is this or sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
f'Y / N ,,qq
so�LMHi—I�f99 )/S
Vato's ' e: P's:
Y /N
If st: f so , List:
a- 19gy -os�t
l 9.8'H -- 0(0 a
SP- �q�y -ocol
2
z -o
viewer to complete the following:
quar'e footage of Use:
Y/N
Permitted as: �� s�„Q 0 ~LPr�•
Under Section:
Supplementary regulations section:
Parking formula: �1 f1 Q - 'p•(/+ 1015 SF NR,-,
Required spaces: 3 (�� AA Q t o d �,VV CI L
Y// N
Items to be verified in the field:
Inspector Name & Date:
Notes
9/28/05 Page 3 of 4
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3/28/05 Page 4 of 4