HomeMy WebLinkAboutCLE200600077 Legacy Document 2014-07-16i
Application for Zoning Clearance a`A;
OFFICE USE ONLY
Zoning Clearance = $35 CLE #
PLEASE REVIEW ALL 3 SHEETS Check # eaeQd1 Date: 3--z9-0(d
Receipt # 6 9a S D Staff.
PARCEL INFORMATION
a
Tax Map and Par'r,el: Existing Zoning CCn tag r n
Parcel Owner: ��%�� ^��L +�.� %S�r Z- P
Parcel Address: 57"/V,' _,aO,'A/%- 9-P City C'IJ99t-O %1�6'S✓C16_ State VA Zip z -z9
- - - -- (include suite or floor) Levi - - - -- L', 3` "50 ICJ �-(-Q I-
PRIMARY CONTACT
Who should we call /write concerning this project? rlo!' ?
Address :13,5_0 Si Y /°fie W City
Office Phone: () WY- /S4 9 Cell #
V0UV%72J>r CCC'State 11X1 Zip OV ,
Fax # �PV` 61a C3 E -mail
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PROJECT INFORMATION
Business Name/Type: %1'�UYJAih/J0 C�11(y /y✓���ZI/V(r f UXLI/ IIIAC_� ,otpZ. c /V(rd'i x.12 /I�ir ('O)VSi1LTV1V%f
Previous Business on this site: si7y�y�72/✓ ��''7 (}3°i2aJ✓
Proposed use: C_
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,,/ ,�/�� Printed % �� � 61
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- - - - - - - - --
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APPROVAL INFORMATION _
Approved as proposed [ ] Approved with conditions $aCiCflOW DILWt•Ce and/(><r
[ ] Backflow device and /or current test data needed for this site.
[�4 No physical site inspection has been done for this clearance.
site plan.
[ ] This site complies with the site plan as of this date.
Contact ACSA 977 -4511, x119. Current Test Data Needed
Therefore,. it is not a determination of to 11tSt�'�� +�l14
Building Official Date
Zoning Official S Date
�T
Other Official Date
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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
Appiicant to complete the following:'
q/ N
o you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
DY / 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.
44 a
Zoning Tech to complete the
Vio s:
i /
f so, ist:
Var' Dc e:
YIf sot:
Intake to complete the following:.
Y
Is um I, HI or PDIP zoning? If so, give applicant a Certified
Engineer's•Report (.CER).packet: p• ; r:.
Wilt 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
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 #
Y qN-
Wire be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Y
Is t ' sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
N
List:
10/14/05 Page 3 of 4