HomeMy WebLinkAboutCLE200600006 Legacy Document 2014-06-20ti0t :iriJ�
Application for Zoning Clearance =] w.
OFFICE USE 4N Y
[Zoning Clearance = $35 CLE # G 6 0e)OD (P .
PLEASE REVIEW ALL 3 SHEETS Check # Date: 1
Receipt # 5 Staff:
PARCEL INFORMATION ('� ( Z(e -� G j
Tax Map and Parcel• '? f x� —co ' (/9��7y Existing Zoning PO '5c'
Parcel Owner:
Parcel Address: P74 8 I o k 1l Pd., WI?;4 F2 City C� "A4 dt Ile, (/
State ,4 Zip
(include suite or floor)
- - - -- -- - - - -- -- - - -•------------------------------------------------
PRIMARY CONTACT
Who should we call/write concerning this project?
Address 0.L &zd" s(, City -s State s -� Zip
Fax # 9 3
Office Phone: ( Cell # L - S'i = r9E mail r {AI��.IQJ tJl4rltG A/ylErUiA. h
PROJECT INFORMATnION�
Business Name/Type: /tdUFYnG� /�f/y�p�t/'[,q� L/93Gj /7ClU/- �iIGP� l�h�l!,�S
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 tt/h''e''m, and that I will abide by them.
Signature) Printed___ �REcr�ill�
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APPROVAL INFORMATION
Approved as proposed [ ] Approved with conditions
[ ] Backflow device and /or current test data needed for this site.
[ ] No physical site inspection has been done for this clearance.
site plan.
[ ] This site complies with the site plan as of this date.
Contact ACSA 977 -4511, x119.
Therefore, it is termination of compliance with the existing
Backflow Device and /or
Ctiz�rent Test Data Neeclerlf
Building Official Date ( 3�
Zoning Official Date Q r� a coo
Other Official Date
------------------- - - - - -- - - - -- -- - - -- c - - -- - 2 = -
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 10/14/05 Page 2 of4
Applicant to complete the following:
-Y /N
Do you 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;
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.
Zoning Tech to comDlete the
Viol * ions:
Y /(N )
If so, ist:
A-(-("
riance:
/N
'ffso, Li t•
� X, - Zaogj° _Gl
ki
195? nq
Intake to complete the following:
Y/N
Is use in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y/6)
Will 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
Y /6
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
ON
Is 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 #
Y /PWill ere be any new construction or renovations?
If so, obtain the.proper Permit.
Permit #
Is /(N�
Is th``fs --or sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
'Y /N
2- ,. 6GO.,
'L i" A- — 260 V -- r,-2-o
2MA 1 `? 7
SP's•
Y /
If so, ,
st:
10114105 Page 3 of 4
Reviewer to complete the following: '�j ��
Square footage of Use: `'C
Y / N V L �fitii�Y(_
Permitted as:
Under Section: '2-�' ` - (A) "e5 4
Supplementary regulations section:
Parking formula: i (� �✓ �� (q5-C)-)o6
Required spaces:
t rns o be verified in the field:
Inspector Name & Date:
Notes
10/14/05 Page 4 of 4