HomeMy WebLinkAboutCLE200600168 Legacy Document 2014-08-20_
�/Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
u
Tax map and parcel:
I Existing Zoning: '
Parcel Owner:
Parcel Address: Z� City�,���
(include suite or Moor) ' State A- Zip 4
Contact Person (Who should we call /write concerning this project ?):
Address `J1�{ 2� bP11V_e_ ^,
- - -- Zip
City [�' F`1Lt+ $�� 8 � SCSI C� State LJ�
—c(
Daytime Phone � �' '1 Cl��i1 S 1 Fax #
l 1 =y _2_3 (.t, _W/ Q E -mail AA 1' ,,, —JA-C,_ "f_ ) V11
Business Name/Type: J .e - 4 ly -.�T
Previous Business on th(i1 s site: � � j�V_b1 ` S l j i
Proposed use: I
Oa
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 - accurate to -the. best -.of my, knowledge- I have.xead. the conditions.of. approval,, and.I. understand them, .and that.I. will
abide b t _ M.
S .ignatttre.of-Business�-wner -or Agent .... _
L��li Chi /fit .
N'\ L
Print Name
a�
AP ,ROVAL INFORMATION lac mw ,.
Approved as proposed L urrent Test Data Needed
[ ] Approved with conditions ntact
[ ] Backflow device and /or current test data needed for this site. Contact ACSA 977 -4511, x119. AAA 97'y -4511, X 129
No physical site inspection has been done for this clearance. Therefore, it is not a detennination of compliance with the existing site plan.
] This site complies with the site plan as of this date.
Building Official
Zoning Official " Date ..21
Other Official Date ,
Date
_ =FOR�OFFIC�E USE ONLY CLE # 2 op , Ob (0 °
Date Paid &- 29-0(p By who? . .
Receipt# % Ck# 417(0/3
_ . By:
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 5/1/06 Page 2 of4
I
County of Albemarle Department of Community Development
01 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 5/1/06 Page 2 of4
Applicant to complete the following:
Do you have one of the following?
VYES ❑ NO
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate)
VyEs ❑ NO
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.
Tech to complete the followinLy:
Violations:
❑ YES R NO
If so, List:
�r
\_�IIwl
Variance:
❑ YES ZNO
If so, List:
Intake to complete the following:
❑ YES RNO
Is use in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
❑ YES 0 NO
If so, give applicant a Certified
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
❑ YES �NO
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 #
❑ YES ED-NO
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
❑ YES E�
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
❑ YES KI NO
If so, List:
SP's:
❑ YES 10
If so, List:
5/1/06 Page 3 of
i
I
L
Reviewer to complete the following: $�
Squar ootage of Use:
YES ❑ NO
Permitted as: n �G
Under Section: �` �� �• Cab
Supplementary regulations section:
Parking formula: a
Required spaces: �✓ r ��
❑ YES ❑ NO
Items to be verified in the field:
Inspector Name & Date:
Notes
511106 Page 4 of 4
Reviewer to complete the following: $�
Squar ootage of Use:
YES ❑ NO
Permitted as: n �G
Under Section: �` �� �• Cab
Supplementary regulations section:
Parking formula: a
Required spaces: �✓ r ��
❑ YES ❑ NO
Items to be verified in the field:
Inspector Name & Date:
Notes
511106 Page 4 of 4