HomeMy WebLinkAboutCLE200600069 Legacy Document 2014-07-08rk .� nL.: •, r,
MAR 2 7 2006
0 0 o x - lYXtuii ' ^.
Applica�ti ®n for Zoning Clcara Nrry DEVELOPIMM
OFFICE USE ONLY
Zoning Clearance = $35 CLE #
PLEASE REVIEW ALL 3 SHEETS Check # Zzz &.9 3 Date: .3--,:R7-069
Receipt #- 5 ci 1 I i Staff:
PARCEL INFORMATION
Tax Mnp and Parcel `- Existing Zoning N
Parcel Owner: u q�1 L , C -
Parcel Address
Lnl City Qx��� State V 4 Zip = I
- - _ - _ _ _ _ _ - (include suite or floor) -
---------------------------
PRINIARY CONTACT (�
Who should we call/write concerning this project ?1 I ` 0
Address : LV I D _L. 0-.11 �� f Y`(� Qa \ City q L'lA
Office Phone: ( Cell #
V Nv Zip Aye o I
Fax #4 9 J0jg0bE -mail M$rQUWg0C SaGAM \V- VA•C.QM
PROJECTINFO IQN
INFO I
Business Name /Type: ff , Do n 11 e LLe V - q eho c.3 ae �F?
Previous Business on this site:
Proposed use: Le -S
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 of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature, U Printed_MMQ 10 2 t T t<' V� I V5 Y��
--------------- - - - - -- - -----------------------------------------------------------------------------------------------------------------------
APPROVAL IN ORMATION
Approved as proposed 'D F-A) 1 ED -DOE--t`0 ND] Approved with conditions
l:. &CIL or- 'PA-r- K I N G F a it "s f-av ICZ- iat o U s rP- y v
[ ] B ckflow device and/or current test data needed for this site. Contact ACSA 977 -4511, x119.
physical site inspection has been done for this clearance. Therefore, it is not a determin don,p c ME wiTlt°C
site plan. lSac ow Device and/or
[ ] This site complies with the site plan as of this date. Current Test Data Needed
Contact ACSA 977 -4511 9
Building Official Date f l� L
Zoning Official ! %S Date 511110,6
Other Official c 4 Date
County of Albemarle D argrrlent1of ommunit Development
A Y P
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -3332 Fax: (434) 972 -4126 10/14/05 Page 2 of 4
Applicant to complete the following:
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; /
V 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. 0 2 2 l
3 0
.- 0 --
Zoning Tech to complete the
Y/
If sc
Var e:
Y/i
If so, -st:
Intake to complete the following:
Y/N
Is n LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y N
Wil 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 /l:)
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
F YJ/ N
(son public water and sewer?
Y /No
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
Y /
Will ere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Y/NN
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
p sp ► aJ SS Q 2�C X02.. TI-h� 7'
D....tF.CIO...
Y /
SP's
Y/i
Sp ;oO4
10/14/05 Page 3 of 4
Reviewer to complete the following:
Square footage of Use: "
ermit ed as: i--)l'U y -LI iCi�1
Under Section: o204.(pat.
Supplementary regulations section:
Parking formula: '
Required spaces:
s`to be verified in the field
Inspector Name & Date:
Notes
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10/14/05 Page 4 of 4