HomeMy WebLinkAboutCLE200600055 Legacy Document 2014-07-08Application for Zoning Cleara
OFFIC:
❑ Zoning Clearance = $35 CLE #
PLEASE REVIEW ALL 3 SHEETS Check #
Receipt
PARCEL INFORMATION 0(1550)-CO -pp— 1 i.2 G0 Q)1 3 - I:j -0� f
Tax Map and Parcel: 3b6o Existing Zoning
Parcel Owner: I_ l� y( v FJ 61 r �✓�S �u ► / v��
Parcel Address: �� �� /wit Dv city.- V Ista Zip L/Z ,� f
(include suite or floor)-------------------------------------------------------------
PRIMARY CONTACT 1�
Who should we call /write concerning this project? d
Address: 7gg4 V,,� a D( City W State VA- Zip ZZCl
Office Phone: ' 3 20)(O: �74DCell # ��"C"C�`t' Fax # E -mail lam' � �U� � l ►7 ��
CADY"
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PROJECT INFORMATIO
Business Name/Type: I/D
Previous Business on this site: LaAv_LL ELL &)
ed use: b M N VW, W06/ Re-7&
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 wn 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 t t es t of my nowled e. I ave read the conditions of approval, and I understand them, and that I will abide by them.
1 vi 5
Signature � Printed [AJ C 'yl QiVtz,_-1
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AP ROYAL INFORMATION
Approved as proposed [ ] Approved with conditions
[ Backflow device and /or current test data needed for this site. Contact ACSA 977 -4511, x119.
[ ] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing
site plan.
[ ] This site complies with the site plan as of this date.
�l
S
Building Official G Date 31 (L I
Zoning Official Date 6 (2Dor%p
Other Official Date
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arle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 1 0/14/05 Page 2 of 4
Applicant to complete the following:
S
Do have one of the following?
Tax Map and Parcel Number and or;
Address of use-(include unit or floor if appropriate;
o
r N
� you have a Floor Plan (sketch or an architectural drawing) that
includes the following, and if so please provide it with the
application?
,oDD s
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 tha the entire structure, note the location within the
structure.
Zoning Tech to
Viola ' ns:
Y/
the followin
N i 36_�=! 1_� , Ijil179 W IF
ce:
/ N
Tf
Intake to complete the following:
Y/,
Is use m LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y
Wil t ere be food preparation?
If so; give applicant a Health Department form.
Zoning review can not begin until we receive approval from
gfalt�ept. FAX DATE
lrpgr—cel 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
// N
on public water and sewer?
N
y
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit. j
Permit #
Y NY��'�1��'
Wire be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
t YIs sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Pro
Y N
If , L' t:
Y/N
If so, st:
-`
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