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CLE200600108 Legacy Document 2014-07-22
Application for Zoning Clearance ❑ Zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS PARCEL INFORMATION OFFICE USE ONLY CLE # Check# C Date: S— i -0fp Receipt #59%7 3 Staff- Tax Map and Parcel: _1i& / 41) ©o o6 % 3 Q o to Existing Zoning %) 54�i A r/' Parcel Owner: Parcel Address: 15 �� V ��G+l . Ci{ w107 o Sdi It —State lV !l Zip %�i��� (include suite or floor) ----------------- - - - - -- - -- - - - - -- - - PRIMARY CONTACT Who should we call/write concerning this project? /a Address: �J � � E .Ql 0 Ci {1 -a 6 ttl'P �430i 1 lu..,State ZipOi o� 7v°' Office Phone: � �� � Cell # Fax # a,1,JZ E -ma' eLq4 tip �J' 00, 9"-Ik PROJECT INFORMATION Business Name/Type: Previous Proposed use: Circle (if applicable): Fireworks / Christmas Tree --------------------------- . S�g Ye,., 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 ce rfy at 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 a*urat4 to the bes f m owledg I have read the conditions of approval, and I understand them, and that I will abide by them. Signature Printed J � �� 1 c ,Y so 1� --------- - - - - -- -------------•----------------•----•------------------------------------ APPR V L INFORMATION Approved as proposed [ ] Approved with conditions �[ ] Backflow device and/or current test data needed for this site. Contact ACSA 977 -4511, x119. jj 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 Date Zoning Official Date J� Q Other Official Date .......................... ...... - - - -,5. _ ... 1....... U ----..-....------......------------------------------ County of Albemarle Department of Community Development 401 McIntire. Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 10/14/05 Page 2 of 4 Reviewer to complete the following: Square footage of Use: Y/N Permitted as: Under Section: Supplementary regulations section: 5 ,Q An 40? Parking formula: Required spaces:er It/ Item a verified in the field: Inspector Name & Date: Notes 10/14/05 Paee 4 of 4