HomeMy WebLinkAboutCLE200600124 Legacy Document 2014-07-24f
App lication for Zoning Clearance v
OFFICE USE ONLY 1 a r
❑ Zoning Clearance = $35 CLE # 7- 00
PLEASE REVIEW ALL 3 SHEETS - Check # /(,q7 Date: A-227-00
Receipt # 1A01-59t Staff:
PARCEL INFORMATION
Tax Map and Parcel:- 1 �!L." �_' Q d Existing Zoning P
Parcel Owner: 10 y 't►,a
Parcel Address:-2-00 Ed U & S C-A1, b N i D K City ( &1e0 V1 WEState A Zip 2M o
(include suite or floor) ----------------------------------------------
PRIMARY CONTACT A w,
Who should w r
e call/ -write concerning this project? I �y 1 D V M M O -PA MA
Address U5 V� DEW 'OLVn• City 6A ft6V1 ReSi tate VA- Zip ZQ �
Office Phone: y3 7q' t1pCell# Igg - loob Fax# 1N' S1tE -mail dAyidzA.1 "ac lm�,rw�'•
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PROJECT INFORMATION
Business Name/Type: Pi4.1 M I V SV I LLI W. SCR b o t,, /at }EGA -G
Previous Business on this site:_ • � Fri VA�r� Sum L
i
Proposed use: {r: Ar 1 �.iTV uL
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 to the best of my knowledge. I have read the conditions of approval, andd I understand them, and that I will abide by them.
Signature f s Printed D AV A �:H /►WV i1 JVn
----- ----------------- - - - - - - -----------------------------------------------------------------------------------------------------------------
APPROVAL INFORMATION
[)o Approved as proposed Approved with conditions ) P 2-oc, 3 b %7
[ ] Backflow device and/or current test data needed for this site.
[ No physical site inspection has been done for this clearance.
Fite plan.
[ ] This site complies with the site plan as of this date.
Contact ACSA 977 -4511, x119.
Therefore, it is not a detef m4
Current Test Data Needed
Contact ACSA 977 -4511, x 119
Building Official Date a i 1 a to
Zoning Official Date 612 71,94 .
Other Official
Date
-- = ----------------------- •------------ •------- - - - -•- ------•---•----•-------•---•----•-------- •-- •-------- .------ - - - - -- -... -- --
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
Applicant to complete the following:
Y/N
Do you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
Y/N
Do you 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, note the location within the
structure.
Zoning Tech to com
Violations:
Y/N
If so, List:
C Y ri ance:
/ Nom;
s o ° 9 -It: b'(
the following:
Intake to complete the following:
Y N
Is I, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet. S L
Abod F yb
O
-ill t ere be eparation? Rl M �0(46-r kootz .
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from
He ( XWt E
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
N
on public water and sewer?
Y/0
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
Y /1
Wi ere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Is /1�f
Is th or sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Y-roffers:
Y/N
If so, List:
d
G bLA�
7 s:
Y/N
f so, st• `
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C,0-01 -7
10/14105 Page 3 of 4
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