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HomeMy WebLinkAboutCLE200600065 Legacy Document 2014-07-08Application for Zoning Clearanc OFFICE USE NLY / ❑ Zoning Clearance = $35 CLE # 6 — PLEASE REVIEW ALL 3 SHEETS Check # 1,9 Cql Dater Receipt # Staff- PARCEL INFORMATION C)&106'66 Tax Map and Parcel: ©b' 6 0() S 00 V-6A ) Existing Zoning `_- 1 ✓ Parcel Owner: Aim 1 Parcel Address: %dp? c' City State Zipd� (i� ude suite or floor) ------------------------------------------- - -------------------------- - - - - -- ---------- - - - - -- -------------- - - - - -- ---------------------------- _ PRIMARY CONTACT �+ Who should we call/write concernin this project? ,,fd 904 54 A-.a Address: 'P 0. /goof 6XS- City da r-<-a- State �%� Zip aa6_3 Office Phone: (SYO Sd'a -3add' Cell # Fax #,530-S1o1- AU, E -mail ,oRr ------------------------------------------------------------------------------------------------------------------------------------------------ PROJECT INFORMATION Business Name /Type: ''S G(/��t/ /A �L� �r�A/Cf A 319A 17"A 7/7ZE'- f�C.�� 0, CIfA.� -UTlG �f ✓GCE" Previous Business on this site: Proposed use: 74f _._A, ex,e.4,41d_" C61it7,9MS/ - CaC40cd f Jf6 -7LC -` t4g—,V J' J-E,ek-✓6-�,T 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 tot e best of my know edge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature a� �� �NI'' Printed qH d m1G -<]Approved ----- - - - - -- - -- - ---------------------------------------------------------------------------------------------------------------------- ROVAL IN ORMATION as proposed [ ] Approved with conditions ckflow 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. Building Official Date 0 Zoning Official l Date 4 Other Official Date �O ------------------- - - - - -- ---------------------- - - - - -- ---------- - - - - -- L, --------------------------------------------------------------- County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 10/14/05 Page 2 of 4 Applicant to complete the following: N YO you have one of the following? Tax Map and Parcel Number and or; Address of use (include unit or floor if appropriate; Q / N 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. ' oning Tech to Viol Y/ If so, st: Vari c Y/ If so, i . the Intake to complete the following: Y / l :/ Is use in LI, HI or PDIP zoning? Engineer's Report (CER) packet. If so, give applicant a Certified Y / Will ere 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 �so N son public water and sewer? V iN ll you be putting up a new sign of any kind? If so, obtain proper Sign permit. Lj� --- Permit # jy� Q � T U Y / Vtere Will be any new construction or renovations? If so, obtain the proper Permit. Permit # Y /�1 Is this or sales of Fireworks? If so, obtain a copy of F/R permit. Permit # Y) / N so, Lis : �� ` T LQ 01 • SP': Y/ If sc 10/14/05 Page 3 of Reviewer to complete the followin Square footage of Use: ) 62s 0 Y/N _ Permitted as: a/►1Myyli�21�C��yG��L4'%�A�,Qd Under Section: o?,2. a?,(. bt 0� Supplementary regulations section`: Parking formula: i �� 0 6.90 J Required spaces: 4 Y /0 Items to be verified in the field: Inspector Name & Date: Notes 10/14/05 Page 4 of 4