Loading...
HomeMy WebLinkAboutCLE200600181 Legacy Document 2014-08-20V 5 bra_ ®I — 00 - 03 /00 Application for Zoning Clearance Zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS b C `/ c61 Tax map and parcel: 1-fo 15 a_ z, J, ltO,t 1, ftll cp,,.I5, 31432- 2 Existing Zoning: Parcel Owner: T t.? T. C Parcel Address: / 0 Tk,,Q / V �� ��ciity C )Ca_C J :-C;0_ , State Vo— Zip (include suite or floor) /� Contact Person (Who should we call /write concerning this project ?): I/r+�f /!r^,� t� �� AL22if j' 1- -� ?1'� r•!� /� /�� r «/,f Address %�ri� / /�s ��'G/�/� f City (_ /� �d Z_ (l<<�/.�_ State Zip !/ Daytime Phone i! L 7L 7 M s Fax # ( E -mail Business Name/Type: Previous Business on� this site: rr, il p , ff? r7 Proposed use: O n 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 read the conditions of approval, and I understand them, and that I will abide by them. 7/17 10 9 natur ofi_ ess Owner X4ent Da r-+ Print Name APYROVAL INFORMATION [ Approved as proposed [ ] Approved with conditions V1 Backflow device and /or current test data needed for this site. Contact ACSA 977 -4511, x119. j [ ] No physical site inspection has been done for this clearance. Therefore, it is not a determination [ ] This site complies with the site plan as of this date. Building Official _ c�X�— Date Zoning Official _ Date JPt7 0'C' Other Official Date FOR OFFICE USE ONLY CLE # 7-0(0(0—/8/ Pee Amount $ A Sr00 Date Paid 7 - z © - ©tiBy who? 7LVLJYAo/1 rA r y- Receipt # (01//C) Ck 6iQ 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 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) K YES ❑ 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. r Zoning Tech to complete the Violations: ❑ YES NO If so, List: Variance: ❑ YES VNO If so, List: Intake to complete the following: F-1 YES [[', , NO Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. ❑ YES R11NO 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 Egl'y"Es ❑ NO Is on public water and -Kwer? VEI Y ES ❑ NO ll you be put ' a new sign of any kind? If so, obtain r permit. ' Permit # NO+ rr 2'YES El NO u� '� v' Z,�1 "' S Will there be any new construction or renovations? ,i 1,1- ,��ZI 0 If so, obtain the proper Permit. Ze)05 —wo M0 Permit # 'ZOO S — ��lr�' /.ri���' f' -Z©06 9 77 Ve l` ❑ YES [t�IO Is this for sales of Fireworks? If so, obtain a copy of F/R permit. Permit # Proffers: ❑ YES EV NO If so, List: SP's: ❑ YES [;T"NO If so, List: 5/1/06 Page 3 of �,Jv A669) rd' Fl.Wt) t 2� Reviewer to complete the following:��Z -�t� ��� � �62l/� Square footage of Use: [YES ❑ NO r pp Permitted as: fo7"z,6 Under Section: , ;z I, t�?- ( () Supplementary regulations section: -yo-- Parking formula: Required spaces: ❑ YES 0--NO Items to be ver'fied in the field: i Inspector Name & Date: Notes 13� L� 4T 1D -'� -6 \ 5/1/06 Page 4 of