HomeMy WebLinkAboutCLE200600174 Legacy Document 2014-08-20rgg,&
Application for Zoning Clearance
� N
OFFICE USE OlY�LY
❑ Zoning Clearance = $35 CLE # 4-
PLEASE REVIEW ALL 3 SHEETS Check # Date:
Receipt # Staff:
PARCEL INFORMAtT —IOQN - n A /�
Tax Map and Parcel: 0 t 900 —0d —W- of �A) Existing Zoning'
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Parcel Owner:
Parcel Address: fN9 L 1�chh.Q.CA I Cityc V ` �� State V Zip
(include suite or floor)
APPLICANT INFORMATION _ n �
Who should we call /write concerning this project? i 1`
Address :2 /g CBEs 6,41yE City State / i/-D Zip -z/o3 7
Office Phone: C1 D6 9S�o -y: i�Q Cell # 410 3)D O Fax # % " / E -mail
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PRIMARY CONTACT
Business Name /Type: ke- n 4 yytu ,r l` �1I'tG� ✓tC i
Previous Business on this site: Amrmos. !��(` {�j � 6ckl- 4
Proposed use: V\ i V1\_GL .'VL 0 1 ✓ui .
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 myknknowled e. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed5�
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AP ROVAL INFORMATION
(.]] Approved as proposed [ ] Approved with conditions
[ ] No physical site inspection has been done for this clearance. Therefore, it is not eterm-imtie Ofd 'til the existing
site plan. Backflow Device and /or
[ ] This site complies with the site plan as of this date. Current Test Data Needed
Contact
- f l
Building Official `. Date
Zoning Official
C Date
Other Official Date
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-= -� - -- - o- - --------------------------------------------------------
ounty of Albemarle De rtment of Community Development
401 McIntire Road Charlottesville, VAZ- a 2902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
App'icaht,to complete the following:
O/ N
Do you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
(§)/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.
Tech to complete the
Vics
if St.
A rr0
Variance:
Y/N
If so, List:
Intake to complete the following:
Y /�
Is use m LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
9/28/05 Page 2 of 4
If so, give applicant a Certified
Y/hWill t ere 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
Y /1
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
Y/N
on public water and sewer?
Y// N
ill you 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.
Permit �(,f-�
Y /
Is th6for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Z�YN
If so, List:
N
—off 5/L � /t�M ,/bl�n, ,'�.•
SP's:
Y/N
If so, List:
Reviewer to complete the following:
Square footagerof Use: se ,
Y/N LL I
Permitted as: -�� IV GjY� NST f i.i i o (,j
Under Section: (Z Z. 2 , %) Z'A . 2.
J
Supplementary regulations section:
Parking formula: l� /SUf�'C2; -�A. ✓ -�J�vA,�, cP� /
Required spaces: /?/ r--�! �4N�oAs CA .5�•��i �e-�
YVN
Ite be verified in the field:
Inspector Name & Date:
Notes
wz -zs1UJ raae S of 4
3/28/05 Page 4 of 4