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HomeMy WebLinkAboutCLE200600167 Legacy Document 2014-08-20zoo & -1& Application for �0cl-� 40: 3 20 i , �- Zoning Clearance r d -7 3 ' Zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS Tax map and parcel: d 00 — 00 �%� / �'� Existing Zoning: V Parcel Owner: Sua C, L. L' C � { ' ` t" l<Q, + PN'4iti Va lea+c_ SeM�nale Cam Maw S � � j Parcel Address: 3415,o Se m i no 1 Y. If-04 City CL r 1] 1 �� State �' Zip (include suite or floor) Sa e xoJ ' _ �p II ,� Contact Person (Who should we call/write concerning this project ?): J 1 ` l � S 461 t L) Address 2 (o 9 / v () (A r o) e � - City � U c ICO��.S� � � `e- State .ti Zipaa 3 �l �'S' 15 3 �. 43 11t'� ' b' I E -mail J i b f ► fj fen f Daytime Phone l © Pew ie 1 CO n-1 Business Name/Type: Previous Business on this site: ✓ [ E— Proposed use: InLea- CL S SGm b ,S-7'b e e SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS 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 accura the est of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by t m. �f�d� e of Business O Z �r►er qr Agent Date S al Print Name Backtlow Device and/or AL INFORMATION 1 as proposed i [ ] Approved with conditions Contact ACSA 977 -4511, x 119 [ ] Backflow device and /or current test data needed for this site. Contact ACSA 977 -4511, x119. 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 Zoning Official Other Official Date ' -I C Date A Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -58 2 Fax: (434) 972 -4126 5/1/06 Page 2 of 4 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) �]/�YES ❑ NO D o 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. , oning Tech to complete the J ■ YES NO ALL If • -- ' 60 - I M III J .- Variance: ❑ YES If so, List: Intake to confifiete the following: ❑ YES NO Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. 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 t® — 7- c ❑ YES [�NO a0� 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 [YES ❑ NO Is on public water and sewer? YES ❑ NO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Uj I [►'YES ❑ NO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # LU i ❑ YES ff NO Is this for sales of Fireworks? If so, obtain a copy of F/R permit. Permit # Pr ers: YES ❑ NO If so, List: V ES F-1 NO , List: j,'6iw��mm%e.r 5/1/06 Page 3 of 4 Reviewer to complete the following: D Square footage of Use: � �D Q,YES ❑ NO Permitted as: %n.Ct.a12C s- a,CCe -e{ Under Section: 414.61 - I C 9 1 Supplementary regulations section: Parking formula: C�i%l (— (✓t -d�D e�- Required spaces: ❑ YES ❑ NO Items to be verified in the field: Inspector Name & Date: Notes 5/1/06 Page 4 of 4