HomeMy WebLinkAboutCLE200600107 Legacy Document 2014-07-22A
Application fog° Zoning Clearance
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OFFICE USE ONLY ,
❑ Zoning Clearance ;-- $35 CLE # 6 A C L��-4� • �(• C�`
PLEASE REVIEW ALL 3 S ETS Checks ## Date: +-1 70
Receipt # StafY: `� 6 L yjJ .-
PARCEL IZVFORM[ATION uJ i C f.- /1 SS 1G N
Tax Map and Parcel: b(Q 65q00 Existing Zoning
Parcel
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parcel Address:— '7726 lr4 U lCO�I �t U�' Ci C a/ 2T0
ty__.....__.- .U. ?�.��- State Zip
include suite. or floor
Who should we call/wizte concerning this project? G1_q a%v 1%f 5
Address.- ae �' °'` Y✓� 7�lTZ D CiCy lw v C ,1 State Zip
Office Phone: t t�l l 21-% --8 l0 Cell # Yax # - �1°�' E -mail e i1 _.10 . Awl,95. C•-,q
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.............•--•--. .......,...........,__,..,..,.. ....... - ------------------
JPTtOJFCT TNFORMATTO -
Business Natne/Type:
Precious Business on this site:
Proposed use: ' � , u� 5 � .. � � .. _ , - �� o _ C��,nJs..3' sev e,m,.
Circle (if applicable):' Fireworks / Christmas free
SP EE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIT;;h:WOKK OR Cif MSTMAS TREE SALES (Sheet 1)
*This Clearance will only be valid on the parcel for which it is approved. If you change, ilitensify ar move the use to a new location, a new Zoning
Clcarancx will be squired,
d
1 hereby certify that I own or have the owners pertnission to use the space indicated on this application. I -also certify that the information provided is t
true and accurate to the be -rtrp ksssr9 a conditions ofapproval, and I undeistand them, and that 1 will abido by them.
Signature Printed____ -. --
- - - - -- td - - -- - - - -- ----------------------------------------------------- ---- - -- --- - -- ---- .,.. -. --
APPItOVAL - -
[ ] Approved prop [ ]Approved with conditions
[ ] Backgow device and/or current test data azeeded for this site, Contact ACSA 977 -4511, x119.
[ ] No physical site inspcotion has been done for this clearance, Therefore, It is not a detennination of compliance with the existing
site plan.
[ ] This site complies with the site plan as of this date.
.Unilding Official -1 �6 Date
Zoning Official D Date"
Other Official irate
-------------- ............... ............. ---
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville,'V'A 22902 'Voice: (434) 296 -5832 Fax: (434) 972 -4126 to /14 /05 page 2 of4
V00 /NOd 020Z =0i 90OZ 9Z add 9Z1VZL6VEV x12A UNICNIAIO AiIN noo
Applicant to complete the following -,
Y/N
po have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
Y/ N)Do 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, dote the location 'within the
structure.
Zoning Tech to
- Vio sons:
Y
Ifs ist:
"Var' ce:
Y /
Ifso, :
the
Intake to complete the following:
Is //N J
Is u n LI, I-IX or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y/N
Will there be food preparation?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from
Health Dept. FAX )DA TE
Y/N
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
YIN
Is on public water and sower?
YIN
Will you be putting up a new sign of any kind? Ifso, obtain
proper Sign permit.
Permit #
Y/N
Will there be any new construction or renovations?
If so, obtain the proper permit.
Permit #
Y/N
Is this for sales of Fireworks?
If so, obtain a copy of M permit.
Permit #
Pro s:
YI
Ifso, st:
WAWWk
Pp
10114105 Page 3 of 4
V00 /EOOd WUOZ =Ol 9006 9Z add 9ZlVZL6VEV X12d 1INIMOIIA3d Aim moo
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1
Applicant to complete the following -,
Y/N
po have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
Y/ N)Do 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, dote the location 'within the
structure.
Zoning Tech to
- Vio sons:
Y
Ifs ist:
"Var' ce:
Y /
Ifso, :
the
Intake to complete the following:
Is //N J
Is u n LI, I-IX or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y/N
Will there be food preparation?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from
Health Dept. FAX )DA TE
Y/N
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
YIN
Is on public water and sower?
YIN
Will you be putting up a new sign of any kind? Ifso, obtain
proper Sign permit.
Permit #
Y/N
Will there be any new construction or renovations?
If so, obtain the proper permit.
Permit #
Y/N
Is this for sales of Fireworks?
If so, obtain a copy of M permit.
Permit #
Pro s:
YI
Ifso, st:
WAWWk
Pp
10114105 Page 3 of 4
V00 /EOOd WUOZ =Ol 9006 9Z add 9ZlVZL6VEV X12d 1INIMOIIA3d Aim moo