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HomeMy WebLinkAboutCLE200600060 Legacy Document 2014-07-08AL�Z 'Application for Zoning ® g Clearance ,. �IRGINIP OFFICE USE ONLY ❑ Zoning Clearance = $35 CLE # Z00&601160 PLEASE REVIEW ALL 3 SHEETS Check # Date- 0 co PARCEL INFORMATION Receipt # Staff• /fQ � Tax Map and Parcel: C? { 0 co -00 ©y —0 31 9U Existing Zoning Parcel Owner: RJ P 1� F✓,o -< 0 &I zzo iv alyzx km l Parcel Address: �� ``� ��Q 140 y IC t�k( State e� Zip - - - - -- - - - -- (include sui a or floor) - - - -- � IX4!Y_?C�- --- - °7� - -- - - - APPLICANT INFORMATION _ Who should we call /write concerning this project? Address: ! ►O Q PArkw °y City C�\,A.4,,44aa v-'i(e State tJ Zip x.31(` _ Office Phone: vt� 9 2 G Cell # Fax # E -mail ------------------------------------------------------------------------------------------------------------------------------------------------ PRIMARY CONTACT Business Name/Type: ""6-L 0 O ✓\ '";� 1 L Q_ O Previous Business on this site: 00,N/ Conk -�cr� �.ch 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 nowledge, have read the conditions of approval, and I understand them, and that I will abide by them. Signature Printed ------------ - - - - -- - - - -------------10------------------------------------------------------------------------------------------------------ P OVAL INFORMATION Approved as proposed [ ] Approved with conditions No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing site plan. [ZlBlackflow Device and This site complies with the site plan as of this date. /or ent Test Data Needed lftcasA 11, x 119 Building Official Date Zoning Official �- `i -���° Date 'a`� UFO Other Official Date `--------------- ------------------------- - ----- -- ---- -- - -- - - -- ___ -_- - ,--_- --- - ----------------------------------------- County lI emarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 Applicant to complete the following: ' N o you have one of the following? Tax Map and Parcel Number and or; Address of use (include unit or floor if appropriate; Q / N o 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. e5 , , _ •. / _ I 10 — / S t - k t- 0 S( 10 0CCO fCnr-r-I .S oning Tech to Viol 'ons: Y/N If s ist: Vari e: 11N I Y / If s AIL t: Intake to complete the following: Y/6 Is use in LI, HI or PDIP zoning? Engineer's Report (CER) packet. N 9/28/05 Page 2 of 4 If so, give applicant a Certified 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 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 /N on public water and sewer? Y/® Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # /N ill there be any new construction or renovations? If so, obtain the proper Permit. Permit " &.:? :Me- Y LN Is this for sales of Fireworks? If so, obtain a copy of F/R permit. Permit # the following: L' 0-4, -2 —'� "� 6C)g Prof Y/N Ifs , . SP's: Y/I If so, Reviewer to complete the following: 21 0 Square footage of Use: N ermitted as: Under Section: 3 Supplementary regulations section: - Parking formula: J�" a 60 0 C -30) = 10 "R 5 CTo) % ? 4 $ Required spaces: Y/N Items to be verified in the field: Inspector Name & Date: Notes yi�siuc race j of 4 3/28/05 Page 4 of 4