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HomeMy WebLinkAboutCLE200600199 Legacy Document 2014-10-03Application for Zoning Clearance hp g �OF A I'fRGIN1P (OFFICE USE ONLY Zoning Clearance = $35 CLE # _ -?-,? )0 — / PLEASE REVIEW ALJ, 3 SHEETS Z Check # A%D -CPe Date: 9- 114 -Of,O Receipt # A/ ©FP 49 Staff: _ PARCEL INFORMATION �e /.1 ,r� Tax Map and Parcel: 6 '7 (� % OCR � � � - (✓ a exist g Zoning Parcel Owner: 1 li/ ,4 r,QD/) C4 Parcel Address:1 -7�g C awcrl & City v- State V Zip (include suite _or floor)_________________ -- ---- - - - - -- - -------------------------------------------------------------------------- APPLICANT INFORMATION --� Who should we call /write concerning this project? ✓�-Sc�-- 6d n U 5PI"A A 90y) G( Address ..37% ? /11DQQ C(Jn ;n �t 94 City Y ,l a State y )q Zip Office Phone: ( � -V-3, S-717 Cell # Ll3q, 11,99, �?ZIZ Fax # E -mail -- - ------------- - - --------- - -- - -- - -- -- -- - - -- - - - -- -- -- -- -- -- - -- -- -- - -- - - - -- - - - - - -- -- -- -- - - - - -- - -- - PRIMARY CONTACT, �' n / p , /� /� jn Business Name /Type: l Co/ ` l / L( �/` i - y 20" bEA A o d 1-i l c Previous Business on this site: Proposed use: -Fo Circle (if NI an T AwFsP 1— Ih(5gk_- E_ 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 to the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. ® 0 Signature 1, &fig Printed ---------------------------------------------------------------- -------------- ----------------------------------------------------------------- APPROVAL INFORMATION [ ] Approved as proposed [ Approved with conditions [ ] No 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. Gil d7iLD Building Official Date ig I .S ( D �- _ Zoning Official Date 7 Other Official �2,P_ /.l ( d Date / -10 ------------------------------------------------------------------=----------------------------------------------------------------------------- County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 Applicant to complete the following: 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; Y/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 N 6s'lo, lations: V1 o aooh. 11 Aa d Var' e: Y'N If so, List: 9/28/05 Page 2 of 4 Intake to complete the following: Y Is LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y)/ N 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 !0 -- / 6 — 0 0 4 k -d ae azi /o -6& -° N07' Is parcel on private well and septic? If so, give applicant a Health Department form. Zoning review can not begin u 1 we receive approval from I Health Dept. FAX DATE ^, (p — o 0 Y / Is on public water and sewer? Y/N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Y N C�11 Wi ere be any new construction or renovations? If so, obtain the proper Permit. Permit # Is Is this16r sales of Fireworks? If so, obtain a copy of F/R permit. Permit # Pro s: Y s , ist: '/ N so, List: 9/28/05 Page 3 of 4 Rev. .jewer to complete the following: Square' footage of Use: jX&O Y N Permitted as: rrrw— Under Section: 6• oZ �• 61 • Supplementary regulations section: ✓ • a Parking formula: Re uir ed spaces: : v / ms to be verified in the field: P,trx GLI `+'' t%Z /5-P .0 70A aA d Inspector Name & Date: Notes 3/28/05 Page 4 of 4