HomeMy WebLinkAboutCLE200600002 Legacy Document 2014-06-20Application for Zoning Clearance
RGINIP
❑ Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
PARCEL INFORMATION
CLE # OFFICE USE/r Z^^ it
V j Cry n-
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Check # Date: /o
Receipt # i Staff: ft "\,A, --
Tax Map and Parcel: -00 =Uo Existing Zoning
Parcel Owner: p
Parcel Address: *85 6 )cl key wick M - for' City % (��� l r k— State VA Zip 22,:U7
________ (include suite_or floor)
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APPLICANT INFORMATION
Who should we call /write concerning this project? f)yijio Wit_ ft. Sfty4VG - -ot2 q
Address :_1 ;,z 6) j - 2 CP -Cc, '0P_t y'C- City _ wilt Si yWg State VA- Zip ZL�Zq
Office Phone: ( f ) Cell Fax # E -mail f)oleg6e rroh
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- - - -- -- - - - - -- -------- 7 -� -- - - -- -- - - - ---------------------------------------------
j PRIMARY CONTACT
Business Name /Type: V)N;d&(_ C_,p2pG13 ot3� c_c.i5 4- pLpNi5 -- RE T(+tL
Previous Business on this site:
Proposed use: 10&�h , & _— a iztr�
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 o or have the owner's permission to use the space indicated on this application. I also certify that the information provided is
true an ccurate to ' best of my knowledge. I have read thp. con 'ions of approv, and I understand them, and that I will abide by them.
Si n thtre- - i
- -- �f - r Printed
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ROVA .......................
L INFORMATION
[ ] Approved as proposed [ ] Approved with conditions
[ ] No physical site inspection has been done for this clearance.
site plan.
[ ] This site complies with the site plan as of this date.
Building Official
Zoning Of icial
Other Official
Therefore, it is not a determination of compliance with the existing
Date
Date
Date
UV_)k_1
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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
--t. h e
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.
Tech to complete the
Viol s:
Y
If s , ist.
Intake to complete the following:
Is us
Is us m LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
9/28/05 Page 2 of 4
If so, give applicant a Certified
Y /
�N,
Will t`l�iere be food preparation?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from
ealth Dept. FAX DATE
P, krcel on private well and septic?
give applicant a Health Department form.
Zoning review can not begin until we receive approval from
Heal t. FAX DATE ^
Is is water and sewer
ill you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
Y/N
Will ere 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 #
Proff
Y/
If so, List:
VIf a ' e: SP's-/A /{
Y Y /
s, st:
If so, ist:
W"viewe,r to complete the following:
Square footage of Use: /
Y / (N) �,.,
Permitted as: e7,
V 0 2 2 e4 S—
Under Section:
Supplementary regulations section:
�)f
Parking formula: r /00 4'r 1,154- /000 -1;e,qjee!jj 6,,�e
14-2 ho �
Required spaces: _ 9
Y / N
Items to be verified in the field:
Inspector Name & Date:
Notes
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J ot 4
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