HomeMy WebLinkAboutCLE200600094 Legacy Document 2014-07-16A
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Application for Zoning Clearance =�
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Zoning Clearance - $35
PLEASE RENEW ALL 3 SHEETS
PARCEL INFORMATION
Tax Map and Parcel:
0btoo 00 00
OFFICE USE ONLY
CLE # 'ZOD fa'_
Check # 421 q bate: - ci0_dtP
Receipt #.5953 42 — Staff: bg
41 0 O Existing zoning ry _
Parcel Owner: T Q �I r � GI, m I � IP r a e r fi e 1, L C (I e a s e d b y -r we Pa, ny�
' O q P v G o r 1 O �e 1✓ Ile, 22 9 0 parcel Address: Cry V Zip
(include suite or floor) _
- - ---------------
PRIMARY CONTiIH J LM s P a I I a, r d �
(-rv� e P a wh- )
Who should we call/write concerning this project? LI
Address: I Y ) O 1 Do u ` ] a f V r i V eCity J vi-h rc� State N C Zip 213 3
Office Phone: 11 C0� # q Fax # (� ✓ �- S E- Gill �6 i
s s ��►
PROJECT INFORMATION )( p r -eSJ --ft 3 20 ((0 h V e h ( ,e 0 c e S -0 K cJ
Business Namefrne•
Previous Business on this site: _ 1 ► ➢ of C 0 v1 V -C h I CV1 rt)
Proposed use! Si k, ( S % Vtr r-c n4-i & 1 0 V1 V -e ki V1 C e s-tb re,
Circle (if applicable): Fireworks / Christmas Tree-
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet l)
'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 1 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 coliditions Of approval, and
� I understand them, and that I will abide by them.
Signature V
Printed X A F 01 t 60A
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A`'PROVAL XN'I'ORMATION
�j Approved as proposed [ ] Approved with conditions
Backflow device and/or current test data needed for this site. Contact ACSA. 977 -4511, x:119.
[ ] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing
site plan.
1� This site complies with the site plan as of this date.
1��Ir11�� 1�.�1�+�` P.1lESllliOt'
Building Official c�t- �-'`'-'� baie I i�� bc
1
Zoning Official Date
Other Official Date
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_'
Coun'�y of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 10 /1 4/05 Page 2 of 4
900 /EOOd W '201 =11 9001 Ll add 9ZOU617E17 RJ LINAVIA3a AlIN Noo
Applicant to complete the following:
QaI have one of the following? S (� p ar)
Tax Map and Parcel Number and or;
Address of use,.(include unit or floor if appropriate;
Do you have a Noer: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. S r r +t 1—CL f
I,_100 +�- r"
Zoning Tech to complete the
Y)/ N
i so, List:
Vic -QjD6S -263
_ _R
a
Vari ),e:
Y /If so, t:
Intake to complete the following:
Is
Is use LI, H] or PDIP zoning?
Engineer's Report (CER) packet,
If so, give applicant a Certified
'VViJJ re 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
Is p 1 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
public water and sewer'?
Y/N
Will be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
,Y l
'1rJill ere be any new construction or renovations?
If so, obtain the proper Permit,
Permit #
Y�
Is tots for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
o, List:
zM A- — 2661 6
3FP�js.� so List:
� (4
10/14/05 Page 3 of 4
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Rev � iewer to complete the follovin -
Square footage of Use:
02-Z
0
Y
as:
sectiol
Ct �- m- kd 100 ao e11"
f Gf o 1 �,t.� -r` Sl, Pe— Q1G-f,\ wo -
Supplementary regulations section: '
Parking formula: A b
I
Required spaces:
Y /N
items to be verified in the field:
Inspector Name & pate:
Notes
10/14/05 Page 4 of 4
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