HomeMy WebLinkAboutCLE201400184 Legacy Document 2014-09-19M
AUG -04 -2014 09:01 AM FREEIIOMFINANCIALSERVICES 3102 326 3801 P.02
Application fox onno. Cleaxax�cl�
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PLEASE REVIEW ALL 3 SHEETS
OP'FICtt USE ONLY
Check # Zl *. 4l q 3i(•y iDatei 9 I5'b y
Pt# 9 70`7 ( WAIT.
Recall
PARCEL INFORMATION
Tax Map And ?aecelr 0 Q -ob — 110 — OqC O usting Zoning G�
���� FC / S •e.•. / 74� �� q q C1-a r
Parcel Owners
Parcel Address: r City
Zip
include al r flo r) .
PRIMARY CONTACT
Who should we call/write concerning this project?
1
vt/�� �►� �K. c �i C#ty . ,' �1A' Zip
Address sa
Phones �, 0 ®11 �+' �1 i SO 1! Fax 4� a�� '�G�.�. l� -snaiN nPSa F IGf ►Dtdv�
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APPT,XCANT INFORMATION
�
Check an that a Chao a of ow�aersbl Change of use Chan of steals® New bta s
11
C4 rc) b tt S Sd le- P nU
Business Nome1I`ype.
Previous Business an this site U
Describe the proposed business Including use, number of employeca, number ofIhMm, available paridng opacm, n'tmbe
C
.
vehicles, and an additional lnformadon tlsat ou au provides a W n b
• �� i a C
It �(e
l s Cleuanae l only he VN'I O &31'roarf for which it is aTrprovod. if you chan`e. in lY or move the use to a caw loastion, a Ir1rY�+
Cleamce vAll bo ragolred.
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pru
1 hereby vmt( � that i r hm the owaor's panel to use the spmw indlamd ort this appliestim. I also aarrtl� that the infirmezion Pru
to o(my owladgpo. I the aondlMoaa of approval, and 1 understand them and theta I will abide by them.
Is true and accurate
C-'a
8 igtletttre Printed
APPROVAL INFORMATION
Approved as proposed L ] Approved with oouditfons [ ] �
( ] B&Mow psevendon device and/or currant test de& noodsd 1br this site. Contaat ACSA, 977.4511, XI I7.
Ther®fbre, It Is not a determination of compliance with The ex!)►fit;
[ ] No physical site Inspection has boon Bono fbr this clearance.
site plan. • I
( j This sita complies with the site plan as of thla data,
Ntlotas t
I
�. Data; C� fic'( I
Building Oftial
Zoning Official Dates >�
V
Other Official Date
County of Albemarle Department os Commul'ALY "irf -UPPRU ., !I
401 McIntire Road Charlott Iliac, VA 72902 Voice: (434) 296.5832 Fax: (434) 9724126
Revlsod 7/07011 Pam bf 3
AUJG -04 -2014 09:01 AM FREEIIOMFINANCIALSERVICES 302 326 3801 P.03
btake to complete the following:
Reviewer to complete the following:
Y E N
Is use In LI, 0 or PDIP zoning? If so, give applicant a Certified
Enginaor's Report (CM pwlmt.
Square fbotago of Use: 3 U D
��ll
C.7/ / N,
Permitted es;
Y/N
WIII there be food preparation?
Under Section: �-
If go, give applicant a Health DoArtmondbrm.
Zoning review can no( begin until we receive approval from Health
Supplementary regulations section:
Dept, PAX DATE
Clrcla the one that applies
Is parcel on prlvate well or pe a7
If private well, provide Health Depattmant forth.
Zoning review can not begin undl we reaeive approval from health
Perking formula.
Required spaces: Z
Dept. FAX DATE
Ciroie the one that applies
is parcel on septic or pub a
Items to bQ verified in the field;
Y/N
Will you be putting up a new sign of any kind7 if so, obtain proper
Sign permit.
Permit
Inspector. Date► —
Y / N
Will there be any new construction or renovations?
Notest
Claaranceer
If so, obtain the proper Permit.
Permit #
.. _• - ; •
"111AIL W suaaa avae+ L►110 ■vuUniu .
Violations;
If A ,, List
Proffers.,
9o, Lixt:
Variance:
I List,
If
sJP'a:
Y /6
If so, List:
'
Claaranceer
SDP's
Rovlsed 711/2011 NO . blf3
a�
AUG -04 -2014 09:02 AM FREEDOMFINANCIALSER'VICES 3102 326 3801 P.04
CERIJ IC.A.TION THAT NOTICE OF TB E
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
,TljlsJbrm must accompany zoning appiteatlons (Home occupadon) Zoning Clearance, Zoning
Admintstralor Determinollow or Appeals, Sign PermUr, ,wilding Perm&) If the appllevtd0tr b not the
owner.
] certify that notice of the application, 4u) dq —es Z-OAPbo '41 4�40es-
[County y application name and number
was provided to � a rihe own ®r of record of Tax Map
[nema(a) f the record o rs o the cell
and Parcel Number -oD ' 10q C-0 by delivering a oopy of the application in the
manner idontliod below; �7
k4na d� �t`k hel4"p-110061 onYo � Ivor ng a py
[Nnmo of the record owner if the record owner ie a
person; if the owner of records is an onttty, Identify the recipient of the record and the recipient's
title or office• fbr that entity]
RE
r:li
Y--1 Mailing a copy of the application to G— qQ4 F-4 0 S a�1 r'
[Name of ►word owner if th err owntkr Is Person,
if the owner of r000id In an entity, identity the recipient ofthd record and the recipient's title or
office for that entityl
Oil Z5 f / to the following addrass:
Data
(address; written notice MAI led to the owner at t e last imowa address of the owner as shown on
the current reel eitst tax usessment boolra or current real estate tax assessment records ntisfies
this requirement].
si nature of Applicant
YJ > ��
Print Applicant Name
15? r4/ -Iq
Data
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FREEDOMFINANCIALSERVICES 302 326 3801
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