HomeMy WebLinkAboutCLE200600054 Legacy Document 2014-07-08a
�.A.plication for Zoning Clearance
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OFFICE USE ON Y
❑ Zoning Clearance = $35 CLE #
PLEASE REVIEW ALL 3 SHEETS Check # / Date: /( 0
Receipt # Staff: 11n
PARCEL INFORMATION
62> :5" l% —6 (o /J
Tax Map and Parcel: C,55( ( ,d(c1 �%�� Existing Zoning 2 0-L
Parcel Owner: Re z 2/1 f _/_/.
Parcel Address: 5cl7tf Jllizl?%I�wS v''!'V 12d- City CkOi-&— State Zip a �
----------------- (include suite or floor
- )
APPLICANT ----------------------------------------------------------------
INFORMATION /00
Who should we call/write concerning this project? Z'q-q?49 PF7),1y,oyJ
Address : �-`I %� ��4>2�11 LA (.,yip kd - City 4t0XzeT State
Zip 22 3a--
Office Phone: Cell # FA5- L9 6 Fax # J�3 - v`1 70E -mail WeA -Vet&c 6ffoC. ",
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PRIMARY CONTACT
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Business Name/Type: ✓ 1(jjN gss
Previous Business on this site: NV>)7�Vg 12)1:551"
Proposed use:
Circle (if applicable): Fireworks / Christmas Tree
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FI, IEE SALES (Sheet 1)
I
*This Clearance will only be valid on the parcel for which it is approved. If you chang _ lcation, a new Zoning
Clearance will be required. I (,(1
r I
I hereby certify that I own or have the owner's permission to use the space indicated on t nformation provided is
true and accurate to the best of my knowledge. I have read the conditions of approval, an' r), ._- . W,u abide by them.
Signature 04� kiOLtlne-A Printed I` 12A kl, fi &Dbmo- m--
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APPROVAL 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 Official
Other Official
Therefore, it is not a determination of compliance with the existing
BacWow Device and /or
Date_ b u 6
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:
L� t el
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.
Soning Tech to com
Viola ions:
Y /
If so, st:
Var' ce:
Y/N
Ifs L'
the
yiy ai�� rage L oT 4
Intake to complete the following:
Y /NN
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y /t Will e 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 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
I/ N
on public water and sewer?
Y/N
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit # --Do nj i" 7
Y /)
Will"teere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Y/N
Is thi or sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
-Prof
Y/N ,
If
SP';
Y/
If sc