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CLE200600194 Legacy Document 2014-10-03
Application for Zoning Clearance I�NIP OFFICE USE ONLY Zoning Clearance = $35 CLE # PLEASE REVIEW ALL 3 SHEETS " Check # Date: `- Receipt # Staff: PARCEL INFORMATION s7 c Tax Map and Parcel: /O �����I OU -d ® �- 0 '%7 &Existing Zoning Parcel Owner: �Es��rlc% �Lso2G ,,,e -; A'Allcc P Parcel Address: 3yV" ,0 1,17Ckr-�14R/ fb City Cam' ✓6��1d,,- ri Cla, at , J1 Zip 22?71 --- -------- ----- -- -- -- ---- (include suite or floor) -------------------------------------------------------------------------------------------- APPLICANT INFORMATION Who should we call /write concerning this project? 01-7 t1; ✓ 6-AIC, �✓ Address :_® 7Ux Zz fo City --,V&SViw-i� State Vii - Zip, Office Phone: (3 Y) 0 413P Cell # Sj / °��r��� Fax # 919Y- ©d 9% E- mail4 Zc�c{ Vle 66)r'rzj''V 11r rNC74- ------------------------------------------------------------------------------------------------------------------------------------------------ PRIMARY CONTACT Business Name/Type: WAT& hz ..i U -yre,V e- 7w- e- �.✓Se:'oE'✓a�i� %�> �p "� ' Previous Business on this site: R08,11vSv n/ 4w 4w,) A% --ou3- c-� Proposeduse: CO�'r -sec S�r�l�� �� �i�ts' ✓oe�.c+c�� �r�.J�% J��P,Q>�r3'1- 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 est of1my kAowledge. I haver conditions of approval, and I understand them, and that I will abide by them. Signature Printed °� liC►n ,�' M61 -------------------------------------------------------------------- APPROVAL INFORMATION [ Approved as proposed [ No physical site inspection has been done for this clearance. site plan. [ ] This site complies with the site plan as of this date. -------------------------------------------------------------------- [ ] Approved with conditions Therefore, it is not a determination of compliance with the existing Building Official •- �— Date Zoning Official Date dlo Other Official Date I W"MAW ------------------------------------------------------------------------------------------------------------------------------------------------ County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 J A ,plicant to complete the following: Y N o you have one of the following? Tax Map and Parcel Number and or; Address of use (include unit or floor if appropriate; Y/N o 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 Vio ns: Y/N Ifs is: � �� _ l/�►Jf7r r1 (z,_r�ll Variance: Y / (I i If so, ist: gr o .., j l �b " Intake to complete the following: v Y Is LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y 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 /P- Is p arcel 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 wate and sewer? Y / Wi ou be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Y / Wil ere be any new construction or renovations? If so, obtain the proper Permit. Permit # Y / /I� Is for sales of Fireworks? If so, obtain a copy of F/R permit. Permit # Prof a s: Y/ Ifs , st: SP's Y / N� If so, List: AP � � �-sk S xev►ewer to complete the following: Square footage of Use: o`ZO(� �o►� r/ N /r,,' mitted as: �' l ��l V ur7 GcGQPK 1L ii� C� der Section: a5 a• t CO z a3 , z 4 e 0� Supplementary regulations section: Parking formula: Required spaces: S C2O0 ' Inspector Name & Date: Notes 9005 60(?o IZor 3 b4 t, r a- 6 �e 4 of 4