HomeMy WebLinkAboutCLE200600185 Legacy Document 2014-08-20AFPfication for Zoning Cleara
OFFIC
❑ Zoning Clearance = $35 CLE #
PLEASE REVIEW ALL 3 SHEETS Check #
Receipt
PARCEL INFORMATION
Tax Map and Parcel: ( ,4' Ndo 6' CC C.. ^ on(1)(")6 Existing Zoning
Parcel Owner: Pere m i Lr P%A Z0. ZL (,
Parcel Address: �%SD �� Bs�ga ld 1? City D 011 &tate Cc, Zip ,l` O/
(include suite or floor) )
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APPLICANT INFORMATION Who should we call /write concerning this project? A�v nela, J14,
Address : /& d4 A?-!5�4 City
4aX1nJfe5✓/ //e State 4. Zips/ '0J
Office Phone: ( ,�F - 915-1 Cell # Fax # •2 E -mail O') w1a Ql @ MS/7, C"
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4* ------- -- -- � - -- - -- - - --
PRIMARY COTn� / P6
Business Name/Type: e: �fjj yD ►n a'G �nC
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 t or have the owne ' permission to use the space indicated on this application. I also certify that the information provided is
true and ac ate to the b st of m now d ve read the conditions of approval, and I understand them, and that I will abide by them.
Signa Printed Dona /a �S . �o k nsoF+
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APPROVAL INFORMATION
f �1 Approved as proposed [ ] Approved with conditions
[ ] No physical site inspection has been done for this clearance. Therefore, it is not a determin tinge 0 ;Vj%X& JWAVing
site plan. Current Test Data Needed
[
This site complies with the site plan as of this date. Contact ACSA 977 -4511, x 119
Building Official `, ,.,.., - r k--� Date 1, j `�1/� ° L
Zoning Official c Date
Other Official Date
----------------------- - - - - -- .�, �- ±- -- -- d- -- - -- -�?�a- - = ---------------------------
Co>�> ty of Albein le Department of Community evelopm t
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Applicant to complete the following:
n %
Y/N
Do you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
(0/ 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
V ill- 1i111CC:
Y
If so, List:
Intake to complete the following: 9/28/05 Page 2 of 4
Y /
�
Is us LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y/6
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
Y /tom
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
}'J / N
Is on public water and sewer?
Y 1(N
1 you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit # t-0; k #pf1
Y/®
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Y/®
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
rroners:
Y/N
If so, List:
SP's:
Y/N
If so, List:
Reviewer to complete the following: 9/28/05 Pa e 3 of 4
Square footage of Use: 'r
,j
Y/N
Permitted as: A r t'fo w�� h i -!-r t� �-�` ✓ �IRi 1� % a�
Under Section: �4-
Supplementary regulations section: / /
Parking formula: / .4Jry �^N��l e. -� �pe� Ar.V+c,� S� ' �7 �w�oYe-
e5
Required spaces: _ z
Y/N
Items to be verified in the field: d .A A _ _ , L _ • f' • n / .
Inspector Name & Date:
—IAVb6
Notes
3/28/05 Page 4 of 4
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