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HomeMy WebLinkAboutCLE200600082 Legacy Document 2014-07-16L.. y/4OB eV,gp! Application for Zoning Clearancec� OFFICE USE ONLY y DoO �� ❑ Zoning Clearance = $35 CLE # PLEASE REVIEW ALL 3 SHEETS Check # Date: Receipt # Staff- ilia -�t— PARCEL INFORMATION (� /`� /`� q �� � C Tax Map and Parcel: (pq� ("`� M O� – vO – 60 1 �i g Zoning Parcel Owner: Aw s° Io JC r1 L L C Parcel Address: ' i 0 S S Sern 1 ,, ole I r City C ►" , o, f I �!Ae V Zip 90–� 70I --------------------------- fin _____ finclude_suite or floor) PRIMARY CONTACT ]) Who should we call /write concerning this project? L dggo MCAT -f� NJ Address : oC��,� V �S`�'q yj p� �ji city C� °tee State V Zip 3 a , Office Phone: 3t 9%3 a 13 Cell # X31" a Fax # X73 ' �$ -mail DjM6//yl�lf j(.1 7� 3 c� I16 +Ma I �� ----- - - - - -- ----- - - - - -- ------------------------------------------------------------------------- - - - - -- --------------------------------------- PROJECT INFORMATION (� /� Business Name/Type: I \ ©t� / � IcAJ A #JDP11'5A-Q _ Previous Business on this site: � AM P A- .: Proposed use: 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 se the space indicated on this application. I also certify that the information provided is true and accurate o?e bes my kn ed e. I have read a conditions of approval, and I understand them, and that I will abide by them. Signature Printed an /� ,tl -4-^ -- -- - - -- -------------------------------------------------------- - - - - -- ---------------- - - - - -- ----------------------- APPROV / N ATION —b [ ]App �d as propo ed [ ]Approved with conditions F 1 J [ ] Backflow device and /or current test data needed for this site. [ ] No physical site inspection has been done for this clearance. site plan. [ ] This site complies with the site plan as of this date. /1. Building Official Contact ACSA 977 -4511, x119. Therefore, it is not a determination of compliance with the existing Date Zoning Official—D",6, -:�SJPALJt• Date T Other Official Date --------------------- - - - - -- - - - - -- - -- - -- � -� - -= �- -- -- �evXp4eff �T t - - -------- Coumarle Department of Comm ity 0-27— . 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 10/14/05 Page 2 of 4 r Applicant to complete the following: O/ N Do you have one of the following? Tax Map and Parcel Number and or; Address of use - (include unit or floor if appropriate; Q/ 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. Zoninr Tech to comDlete the followin . Ys v I L. g - L � e � _ ZCaD V a rjan ce: Y M Ifs t: Intake to complete the following: Y /NIs us n LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y / 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/0 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 V/ N s on public water and sewer? N Will you be putting up a new sign of any kind? If so, obtain )roper Sign permit. 3ermit # 1Q /14 /US Pages or'4