HomeMy WebLinkAboutCLE200600001 Legacy Document 2014-06-20Cr�vL Al m t
lipl Cation for Zoning Clearance
Ob�"TCE USE ONUY•
Toning Clearance= $3.5 CE L # zoo b .
PLFASE'RLrYMW ALL 3 SMETS. Cbeck # .37-7 M0 Date: 1 -.3 -C
Receipt # X17 g n Staff: Ile
PARCEL WORMATION y
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Tax Map and Parcet:
' Parcel Owner: i !�
ParielAddreas: �'.
(fa�iude suite or door) Cif �tatc zip ZZ74$
ANC�ORMAHON .._.. - -- -- - - - - -- - - --
• .. SIC - - - - - -- ----------------'-----------]-�-----
Wiiv'&OUJON cel�'i Ate eMceming
Address! ��.✓gvibotr�C �l'- t7)C �i'a
�1 City �l`w?1� slate V^ zip a 3 aaec�
0,ffice Prone: dtb Cam(, cell #f
Ce
_ _ _ Eze # W-'al ALf E -mail
.Y CONS- - �CT
----------- . ------------ W----- ------------ - - - - -- --------- - - - - -- -----------.-------
�s�ness 1�lamertppe: � � n �x: l co v - I�v� o �• e �� , `•�., � ,,� �
--J
Psevagusiness ¢u this site:ybi L xA,:rV
iPro Qst: ��- -;�.�� OCR +�Y� Bp? (�;�•�t' - 4
Girale:(if.dpglicable): l travrorks / C 11,h.tmns'Tree
SEL CONDMONS OP APPROVAL M TAX CLEARANCE IF,• FOP, FUMWORK OR CMI S TREE SALES (Sleet 1)'
`This Ocarance wfu only be valid m tho p a*ou for whi6 it is a}5prbvodr If you changes, iat-.usify or mo` c Cho gse to an
6W coca oA a now zoning
Glearancc• }rill be regeure8.
.I hctcb_v ccnity tharI own or havo the Qwnes's permission W use the Space indicared on this application. I also
Irdc andsioci� ate t4 lute best ofkrty imowledgo, •havgtead the conditions of a rov and I understand Ih �.i Vi0 irrAm Iron provq� is
Lq , r f�..ic ►n� u PP em, andtitat C will abide bythem.
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Sfp�t�e An e- i ' ted r T lo 5
----------------------------- -��---------------
-
PROVA- INFORMATION -- - -- ---- - - - - -- a
A�oved as proposed naltions st r�
[ ]'No' sit�I site •
PhY irrcpcctio� }ids been doo or thus clearance. Therefore, it-is not a detazminatioa of comp e e
' ''site }ilaii,
Ttis 3"Ot compllos with the sits pim of
' r
Date lZ
Date, •
Ofl,.er Mcw
Date
--- - - ----
--- ------- - - - -_- - - - - --
------------ ------------ - -� - -- -----------------
CQUnty Of Albemarle Department of Cflmmunity bevejopmeht ---- --- --- -- - - -` -- - - --
401 McThtfre Road Char]oitesviIle,'V"A 22902 Voice.- (a34) 295 -5832 psz: (434) 972-4126
900 /S00d mdemo soot lZ AoN 9MUREV "d t1OHOI3Qo A1lNnWWoD
£00A00d W899.60 9002 U qaj 9ZLVUBM xcd UNAKIIA]a Al HANN00
A41jeant to complete the following:
you h Ve one of the following?
Tax Map attd. Parcel Number and or, '
Address dfuse (haelude unit or floor if appropriate;
Do you havoc Floor p1m (sketch or an arehhtzt =l drawfng) that
includes the following, and if so please provide it rviflt the
application?
The fotai sgpare footage of the use and/or, -^ 171 f-
e sc�taze footage of each room or area of use;
Use of eeoh room or area
if Usigg Ieaa than. the entire 5fruontro, hero tho I.von within the
IN I J,
yl1WUJ Paget of
Intake to complete the followaing:
use in LT, I-I or PDIP zoning? if so, give aRpHcmt a Cmffled
Engineer's Report (CF-?,) packet e)(�
Y�
WfaU be Food preparation?
If so, give appEcarit a Health Deparrzztens form,
Zoning review cite not begin until Wo rccoivo approval from
Health Dept. FAX DATE
P, �n pdvata wall g�j ?
+, give nppliceat a );Noahh Dapartment form.
Zoning review cats riot begm until We receive Vproval from
1164hL ' ePt. ]VAX DATE. -
water and sewer?
!YIN
Will you be pu#g up a new sign Of any .kind? If -so, olxain
proper Sign Permit;
Perau9t it
YIN
Will there be wy new conaftu* Won or renovations?
If so, obtait: the proper Permlz.
Permit #
YIN
Is this for cafes o €Fire'works?
If SO, obtain a copy of FIR permit.
Permit #
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