HomeMy WebLinkAboutCLE200600100 Legacy Document 2014-07-22Application for Zoning Clearance
OFFICE USE ANLY
❑ Zoning Clearance = $35 CLE # U VX
PLEASE REVIEW ALL 3 SHEETS Check # Date: t- �Z 6
Receipt # Staff: -_ M1411U7
PARCEL INFORMATION �,�} ��
Tax Ma and Parcel: (9 �C t�� 00 —oo ` nl n 1
Map Existing Zoning C;
Parcel Owner: 0-� ^�r;IZ A [J `)
X&e S) / r14
Parcel Address: �3 �� hul ^� °L �lZ��FI City C ( LL u"CState V& Zip �—� �` v(
(include suite or floor) ------ - - - - -- -------------------------------------------------------
- --=---------------- •----------------------- - - - - -- ----------------- - - - - --
PRIMARY CONTACT L
Who should we call/write concerning this project?
Address: �` �% iJ o'L 3 1 City &,r [js V i l State U j1 Zip Z2 t 3
Office Phone: ��`� - -?'.5- -'Y133 Cell ON Z`1 Z" q'i(Fax # E- mail c[� ��
------------------------------------------------------------------------------------------------------------------------------------------------
PROJECT INFORMATION
Business Name/Type: OS SCS S I op\�S 2 o_j C (_6
Previous Business on this site:
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 use the space indicated on this application. I also certify that the information provided is
true and accurate,@ the best of my kn .. W edge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature 'lC t\ �%� Q i' Printed ko 62f K ° ry & t' o
- - ---=---------------- - - - - -- ---------------------------------------------------------------------
APPROVAL INFORMATION
[1/f Approved as proposed [ ] Approved with conditions
[ ] Backflow device and/or current test data needed for this site.. Contact ACSA 977 -4511, x119.
[gyp] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing
site plan.
[ ] This site complies with the site plan as of this date.
Building Official
Zoning Official
Date
Date �f /0'
X 119
Other Official Date
-- ------------------ - - - - -- ---- -- - --------- .................................
Coun of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -41.26 10/14/05 Page 2 of 4
Reviewer to complete the following: 5�
Square footage of Use:
N�-
ermitted as:
Under Section: A)" a • � a C �� ` � � ` ° ' � ` �
Supplementary regulations section: 6
Parking formula:
Required spaces: 0W �,tt, a
Y/N
Items to be verified in the field:
Inspector Name & Date:
Notes
IV/ i -+iw ragc -r