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HomeMy WebLinkAboutCLE200600187 Legacy Document 2014-09-29Application for Zoning Clearance ❑ Zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS f ® � ® /P q Tax map and parcel: �^ 31 �j A- i Existing Zoning: t' Parcel Owner: 9 LLC- ` GS-IL'gg 1AMC, NLf1'L.1A-e', Parcel Address-.3iq 2L-1i5 17JP.o City CLri Lt� S Vl, State V A . Zip 22 (include suite or floor) . Contact Person (Who should we call/write concerning this project ?): ✓ q& C A qr Address J W0 S-'A �7ibeT Eli 1-M b City ��h0� � J l � �- State VA. Zip 72� 0_ Daytime Phone (� 172, O Fax # L_) E -mail 1AA*.]E-J- tM 0- A - 1esWAkULF OL& Business Name/Type: A q EN kktz &I-CW HE Previous Business on this site: t P'rC w o q Tj4a Proposed. use: TiA', o4 G f;2 u k1 E14-co tmae - OFD e,13 — %-�f5s 2d o ( Le2,- etA.uIF a Live knows 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 tha 6at have the owner's permission to use the space indicated on this application. I also certify that the information provided is true a to th e best of my knowledge. I have read the,conditions of approval, and I understand them, and that I will abide by them. , , n Owner or 111.E %►.�?�it�c. -- Print Name L&Ei It 4,.E (S�UJT-� ?vv6CE 1� TuL' bG Date APPROVAL INFORMATION [ 14 pproved as proposed [ ] Approved with conditions [ Za,kflow device and/or current test data needed for this site. Contact ACSA 977 4511, x119. 7[ physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing site plan. [ ] This site complies with the site plan as of this date. Building Official Date -© Zoning Official Date _ Other Official_ Date o rr — 0e FOR OFFICE USE ONLY CLE # Fee Amount $ Date Ppi By who? eceipt # ��Ck#�_p_ �_ By: fir+ A nA �P .v n w An l d P C Aj A // del/ �e B County of Albemarle Department of Community Development Q 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5532 Fax: (434) 972 -4126 5/1/06 Page 2 of 4 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) ❑ 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. Tech to complete the V ❑ YES NO If so, List: J Var ce: YES ❑ NO If so, List: x In ake to complete the following: ?,P-Y-661 YES E] NO ®hk-' s In in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. ❑ YES NO Will there be tbod 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 pNireel 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 ❑ YES j< NO Is on public water and sewer? [:1 YES ❑NO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. �J Permit # l , ❑ YES ❑ NO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # ❑ YES NO Is this for sal of Fireworks? l If so, obtain a copy of FIR permit. I Permit # ■ YES It • If so, List: SP's: ❑ YES If so, List: s 511106 Page 3 of 4 Reviewer to complete the following: Square footage of Use: V u V VYES ❑ NO Permitted as: ; C UPC Under Section:. '541 ' at �� �� Supplementary regulations section: aj,-I ,C. t4 Parking formula: f 2IAL I t C-4,5 fi Vt'_a Required spaces: {�J wg^LL ❑ YES ❑ NO Items to be verified in the field: Inspector Name & Date: Notes 511106 Page 4 of 4