HomeMy WebLinkAboutCLE200600170 Legacy Document 2014-08-20Applicat *oWfor Zoning Clearance
OFFICE USE ONLY
oning Clearance = $35 CLE # x y U C �� 7
PLEASE REVIEW ALL 3 SHEETS Check # rJ o' 5 Date: -C
Receipt # Staff.
PARCEL INFORMATION �{� ----�
Tax Map and Parcel: J' / �-7
— —3 Existing Zoning ,
Parcel Owner: & V4& P/C'SP✓y4� " L L C
Parcel Address: I / (C �G' City eV- 1^ 6e-14c&_State Zip s �'
(include suite or floor)--------------------------------------------------------------------------------------------
PRIMARY CONTACT
Who should we call/write concerning this project. ' 0
Address : 2� TAO �C� 91Go- P fl t 1, l p� City State lam /? Zip 2- -9 %
Office Phone: ( � , r - 2 —U J 6 %Cell # �,JNV2 -7 NFax # E -mail 1-04t � 4r.1, e-, x--
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PROJECT INFORMATION /� JJ
Business Name/Type: A" le
Previous Business on this site:
Proposed use:
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, and I understand them, and that I will abide by them.
Signature
Printed �6 — '4'
-- -- - -- - --------------- - - - --
APPROVAL INFORMATION c
[ ] Approved as proposed j�Approved with conditions '<�22� J
[ ] Backflow device and/or current test data needed for this site. (Contact ACSA 977 -4511, x119.
[ANo physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing
ate plan.
[ ] This site complies with the site plan as of this date.
Building Official
Zoning Official
Other Official
Date -L (S Q �.
Date 9 0
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
plicant to complete the following:
01
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
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.
Zoning Tech to com
violations:
If Bost:
Varl ce:
Y /
If so, List:
the fn
Intake to complete the following:
Y
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Yj/ N
ill there be food preparation? A '
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from
Health Dept. FAX DATE f7 I (,p S.w
J ,Y)/ N
parcel on private well and septic? 14r
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from
Health ept. FAX DATE _ {p
Y/N
Is on ublic water and sewer?
Y N
Wi ou be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
Y/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Perm' #
Y N
Is th for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
Y / /1V J
If so, /is t:
/ N
If so, List:
10/14/05 Page 3 of 4