HomeMy WebLinkAboutCLE200600117 Legacy Document 2014-07-22O-a'u I -03193
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Application for Zoning Clearance
OFFICE USE ONLY p '
Zoning Clearance = $35 CLE # z Od - 1-7
PLEASE REVIEW ALL 3 SHEETS Check# W10 Date: S-1-R-00
Receipt # 6000& Staff:
PARCEL INFORMATppI��ON Q/ I p c
Tax .Map and Parcel: iJ g500 ~ 00-00 OW 1 O Existing Zoning 1 V
Parcel Owner:
Parcel Address: ct (l CVin kit, City C it 1 J It State � � ZipJ J j d
(include suite or floor) - - - -
(include suite -----------------------------------
PRIMARY CONTACT >
Who should we call/write concerning this project? �ih.�( 1`
Address:: o di-e � 14tov' e i city (?�� 1 ✓ t State Zip d J /a
Office Phone:
Cell # °I ho LqsI Fax # `� kI e%` q-0 —"% -il
------------------------------------------------------------------------------------------------------------------------------------------------
PROJECT INFORMATION
Business Name/Type: �-
Previous Business on this site:
Proposed use:
Circle (if applicable): Fireworks / Christmas Tree
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OI `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 to the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
r.
Signature _L1,' 1421,� i Printed ,Q , I a
------------------------------------------------------------------------ ------------------- - - - - -- ----------------------------------------------
APPROVAL INFORMATION
[ Approved as proposed [ ] Approved with conditions
[ ] Backflow device and/or current test data needed for this site.
[ja No physical site inspection has been done for this clearance.
rte plan.
[ ] This site complies with the site plan as of this date.
Contact ACSA 977 -4511, x119. .
Therefore, it is not a determination of compliance with the existing
Building Official
Other Official Date
•---•-----------•• .................---•---•---•---•----•--••---••--•-------•-•--•--...--••--••---•-------•----------- ...--- •- •-- •- •-------- ......
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -41.26 10114105 Page 2 of 4
Reviewer to complete the following:
Square footage of Use: TI�GI
ly N
rmitt ed d b 1
Under Section:
Supplementary regulations section:
Parking formula:
Required spaces:
Y
Ite /N be verified in the field:
Inspector Name & Date:
Notes
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