HomeMy WebLinkAboutCLE200600079 Legacy Document 2014-07-16-. -27 -2006 16:37 From: ll ®� 3
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Application for Zoning Clearapee
OFFICE USE [
(''U #
Zoning Clearance = $35 Cheek # a,5-q
PLEASE REVICW ALL 4 SHEETS Receipt #-159
PARCEL INFORMATION
Tax Map and Parcel:
Parcel Owner: I O 0 s �
Parcel Address: t{ t ��aEt1'tG
---------- --------- - - - --- - ludest
APPLICANT INFO l
Who should we callCwrite cern
Address : -60
Office Phone: ( —la-1)
PROJECT X. TIO?
Bucincss Numc/1'
Previous on th sit0�
% / -. - - -- Existing Zoning P.J
C�tcrtfl-1t�s� :� t, State VA 71D 729
or flgor�
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L'c x3 ^ V�� State V tr zip
F'ax # �2—'754Z F Mail r y�
Circle (ifapp' Wo): F" ork . /' C Troe
SE =ND1 NS APPROVAL T �' CLEARANCE 13 FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet 1)*110 y be validontheparsci forw dt itis approved. lfyou changes intensiiyormove iho use tQ anew locarioty a new Zoning
Clearance will be %utmd
t horeby certify 31 own or hsvc the owner's permissio use the space: indicates on this application_ [also certify that the infornntion provided is
true and accurate the beat oCmy howl = T have ie conditions uFippmval, and TT a nderstanndd Them, aafml llut l Iwwiill i ffhide by them -
Signature '�~ ti ~Tinted
V f
APPRO iLL INFORMATION
( ) Appm as proposed { ) Approved with conditions
Btuldin Official — _ _ . Date
:coning Official _ JD ate �
OthQrt)ffit:ial Rate 1 �
-------------------------- - - - - -- ----------------------------------------------- - - - - -- - --
County of Albemarle Department of Community- Development
401 Meln-hre Road Charlottesville; VA 22902 Voices (434) Z96 -5i$32 Fax. (434)972 - 412+6, �
3/223105 Page 2 of+l- - - -.._
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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;
Y/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.
Zoning Tech to com
Violations:
Y/N
If so, List:
Variance:
Y/N
If so, List:
the
Intake to complete the following:
Y
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y Ptere
Wi 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
Y I N
s on public water and sewer?
Y nN
Wil you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
Y
Wi ere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Y
Is or sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
Y/N
If so, List:
SP's:
Y/N
If so, List:
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