HomeMy WebLinkAboutCLE200600089 Legacy Document 2014-07-16A
Applicati for Zoning Clearance - �-
OFFICE USE ONLY -2- �-yc/ „ _ ,S 9
Zoning Clearance a S15 CL,E # l d lL�
PU ASF REVIEW ALL 3 SHEETS check # � Date: i-4-14-OW
Receipt # G G Staff
PARCEL INFOPMATION a q- -D�
Tax Map and Parcel: V (76 9� Existing Zoning
-----,Parcel Owner: gawk �Kq"_ N�sSe:p A�) S I JJ C- e
Parcel Address: qql& e� _gwd city �A &ade - State VA- zip
(include suite or fl oor) ... ........ ....................... --
.- 11.11 \
l'RIMAR`i'' CONTACT' `n , r �
Who should' ealltwrite concerning this project? hn � �� Q ( l Yl, ( 6C Y_
Address: +734z Pt4gV_ IZoczc . City A 2zjt State VA_ Zip 7iZ�2-0
Office Phone: �J ell # �% 1 ax # ��a E -mail
... .............. - - - -1 � ...
PROJECT INFORMATYQN' --- ••-- - - -
- -- ------- �V...- - - - - -- -
Business Namarrype: AA 1 Cq U )-C-_1_--JJ65S KAM _.
Previous Business on this site: V 1 G( l
Proposed use: C.�t'`(d y Tu k- 3kcy\
1\)S—rt [IA.TiL 0,(-
Circle (if applicable): Firework's 1 Christmas Tree.
SEE CONDITIONS OF A)PPPO''VAL IF THE CLEARANCE JS FOP. 4YIMWORK OR CHR
*This Ocarincc will only be valid on the parcel for which it is approved. If you ebango, intensify or move the
Clearance will be required.
I hereby eerttfy that I own or have the owner's permission to use the space indicated on this application. I also eei
true and accurate to the best of my knovel4dge. I have read the conditions of approval, and I understand them, and
Signature printed i ra
TREE SALES (Sheet 1)
w location, a ne Zoning
information pro vi is
11 ab c by them.
-. •--•------------ - - - - -- ---1111----------- - - - - -- ..1111.- 1-------- - - -...
APPROVAL INFORMATION
Approved as proposed [ ] Approved with conditions
Vfl [ ] ckflow device and /or current test data -needed for this site. Contact ACSA 977 -4511, x119.
o physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the
site plan.
[ ] This site complies with the site plan as of this daft.
Building Official Date
Zoning Officia Date
Other Official q �Date
--------- - ----- ounty o Albemarle Department owl' Community�Development V V - -- - -- - .Y-�V - -
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 10114105 Page 2 of 4
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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 Ilan (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;
-'i he square footage of each room or area of use;
—'.(se of each room or area
--'If using less than the entire structure, note the location within the
structure-
mooning Tech to
Viol ns:
Y /n
Ifs t:
If
the
Intake complete the following:
YIN
Is se ' LI, I II or PDIP zoning? If so, give applicant a Certified
Engineers Report (CER) packet,
Y /%
Wi ere be food preparation?
If so, give applicant a Realth Department form.
Zoning review can not begin until we receive approval from
Health Dept. FAX DATE
�N efeY' parcel on private well and septic?
If so, give applicant a Health Department form.
Zoning roview can not begin Until we receive approval from 1, �4-)
health Dept. FAX DATE -4-1 4 -O U
Y t F- �Cc�cC l 5
Is on public water and sewer ? %
Y /Y
r
Wil ou be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
Y /1)W t er ie be any new construction or renovations?
If so, obtain the proper Pennit.
Permit #
Y/! QN) Is t sales of Fireworks?
If so, obtain a copy of F/R. permit.
Permit #
Y) / N
-if so, List:
/N
4 so, List:
6q 3
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10/14/05 :Page 3 of 4
Reviewer to complete the I'alYowing:
Square footage of Use: J
Y I.N.
Permitted as;
UndcrSectiOn:
Supplementary regulations section:`
Parking formula: l / 020 0 G,,Y o)
Required spaces:
Y/N
Items to be verified in the field:
Inspector Name & Date:
Notes
10/14105 Page 4 of 4
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