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HomeMy WebLinkAboutCLE200600076 Legacy Document 2014-07-16pF AfgE,j Application for Zoning Clearance 4"AFJv �•rr�r�l` OFFICE USE ONLY Zoning Clearance = $35 CLE # Z 00 co- PLEASE REVIEW ALL 3 SHEETS Check# .5111 Date: 3 -Z4-040 Receipt # 5q,!2 -7!? Staff: PARCEL INFORMATION Tax Map and Parcel: 26- ZNIY Existing Zoning UIL Parcel Owner: 5e-f -et ., T / 7L,/ 5 T Parcel Address: '' ��' aS ftl2IZz`'l 5 jCity �f1 ��� "L� State /C(' Zip aqo (include suite or floor) --- --------- - - - - -- - - -- -- - -------- - -- - - - - ------------------------------------------------------------ PRIMARY CONTACT ` Who should we call /write concerning this project? l lid Oge7c'--,�� it 7 Address : =� ©U - C�;��� {C /C�Ce City V State G�C� Zip Office Phone: l d %J - 1)U%',55ell # gg,�-'35 /t, Fax # — E -mail _ p,,r.,-- Sa %y P ------------------------------------------------------------------------------------------------------------------=--------------------------- PROJECT INFORMATIO� / 9 Business Name/Type: raC- �I'm sa l�wlel Previous Business on this site: 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. 1 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 le best my knowledge. I ve read he conditions of approval, and I understand them, and that I will abide by them. // �,� / �]' ) , Signature ,l Printed W G f � ----------------------------------------------------- - - - - -- ------------------------------------------------------------------------------------ APP ROVAT, INF OR1'.1rATION - - - - [Approved as proposed [ ] Approved with co C kiow mi ce andioi Backflow device and /or current test data needed for this site. Contact ACSA 977 -45 elt Test i)ata Nmded [>�No physical site inspection has been done for this clearance. Therefore, it is not a deVAMAl9"11tbX1U9c ting ite plan. [ ] This site complies with the site plan as of this date. Building Official 4 ��„ �� L� Date Zoning Official - Date 5/f /d(, Other Official Date --------------'------___--- ---------- ^------- ------ �'a °V'T -'Y--- - -^'_'O_Y_"___--_-- L --------------- - County of Albem aleDepartment of Community Deve opment . 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 o you have one of the following? Tax Map and Parcel Number and or; Address of use (include unit or floor if appropriate; CYO/ 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. o00 Z 1 old r ' Zoning Tech to complete the following: Viol s: Y / If so, 'st: 0 ariance: Y/N f so, ;st: 1/k- I Es'- 63� o f2 c'"c� Intake to complete the following: �� �'2� Y N q- 21 -biv : CR;�ed use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packef. Y Wi 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 '. I, 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 s on public water and sewer? Y/ Wil you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Y / l�j Will ere be any new construction or renovations? If so, obtain the proper Permit. Permit # Y /f�I Is t ' or sales.of Fireworks ? -- If so, obtain a copy of F/R permit. Permit # SP's: Y/ If so L' : 10114105 Page 3 of 4