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CLE200600131 Legacy Document 2014-07-24
�1 Application for Zoning Clearance -t Zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS zooc- ��l Tax map and parcel: Q-77 C i 0 j " 00 " 60 % ©Q Existing Zoning: R -4 Residential Vim_ Parcel owner: Current Owners: Norman and Rebecca Lindway New Owners: Carolyn M. Patterson & Robert B. Goss Parcel Address: 1188 Scottsville Road city Charlottesville State VA ZJp22902 (include suite or floor) Contact person (Who should we ca11/write concerning this project ?): Robert B. Goss Address 4022 Sea Bird Way City Ellicott City State MD Zip 21042 Daytime Phone 4(- 10� 313 -8692 (443) 857 -7042 (Cell) Business Nam,etrype: Inn at Monticello Fax 4 t 41 465 -1837 -- Bed and breakfast inn Previous Business on this site: Bed and breakfast inn Proposed use: Same. No proposed changes in current use. &mail robertgosslaw @comcast.net SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOA FIREWORK OR CRRISTNM TREE SALES (Sheet 1) Circle (if applicable): Fireworks / Christmas Tree *This Clearance will only be valid on the parcel for which it is approved. If you change, intensify or move the use to a new location, a new Zoning Clearance will be required. I hereby certify that I own or have the owner's permission to use the space indicated on this application. I also certify that the information provided is true and accurate to the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. 05/26/06 Signature of Business Owner A Agent Date Robert B. Goss Plint Name APPROVAL INFORMATION 1 1 Approved as proposed [ Approved with conditions [ ] Backflow device and/or current test data needed for this site. Contact ACSA 977 -4511, xt 19. [ j No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing site plan. [ hispife c liens wills site Ilan ofilti te. /1� � �` Al A Building Official Datc`go B$�a/'&y1 n CA Zoning Official Date Imnt ed Other Official f r_z;',e, Date t Ct ACSA 9774 e + +, 2119 FOR OFFIC ONLY CLE ZC�D (n •- /3I Pee Amount 5 G' Dalo Paid r - 3D ,� By who? �� "?_- `�'>'_1 _ Receipt # Qi4� Ck# By: _11��i 7f n �� _ C7- County of Albemarle Department of Community Development 401 McIntire )!toad Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 9724126 5 /1 /06 Page 2 of4 Applicant to complete the following: Do you have one of the following? YES ❑ NO Tax Map and Parcel Number and or, Address of use (include unit or floor if appropriate) U YES ❑ NO Do you have a FIoor 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 c Violations• [I YES .t NO If so, List: the Variance: '/ YES ❑ NO If so, List: p Intake to complete the Following: []YES j1 NO Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. 83 YES ❑ NO 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 DATE JIJ 6t. A q 2 ❑ YES [YNO W 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 E3 YES ❑ NO Is on public water and sewer? ❑ YES LYNO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑ YES [KNO Will there be any new construction or renovations? If so, obtain the proper permit. Permit # ❑ YES a NO Is this for sales of Fireworks? If so, obtain a copy of F/R permit. Permit # 9 soffers: YES F1 NO , List: ZAA zoas-13 i SP's: ❑ YES 2 NO If so, List: 3 /1 /06 Page 3 a£4 i Reviewer to complete the following: j Square footage of Use:�� ❑ YES ❑ NO Permitted as: csr-.: L;, ...: •.a/ Under Section: 151"1"1 Supplementary regulations section: Packing formula: ' per' Required spaces: YES ❑ NO Items to be verified in the field: _ e -A) 0A-( VAY4i� -� Inspector Name & Date: Notes 511106 Pap 4 of 4