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HomeMy WebLinkAboutCLE200600203 Legacy Document 2014-10-03I Application for Zoning Clearance OFFICE USE ONLY CLE # � /Zoning Clearance = $35 Check # 7 Date: PLEASE REVIEW ALL 3 SHEETS Receipt # 1 !v ©n2_._ Staff: PARCEL INFORMATION r ���z ! Ja y 9 Existing Zoning Tax Map and Parcel: 93 1/ _5D1f° #116b, t Z,ZAC_ Parcel Owner: qq� ��� �� zl� 0. ] City /�4S'tK.�s ci ,.. Parcel Address: G' y % �- Zip (include suite or floor) ----- ----- - - - - -- State PRIMARY CONTACT �I Who should we call/write concerning this project? � 1. State Zip City Address : 3 2'�• /nom rc Office Phone: (� i T7 —�5JO Cell # ilt'! - ' j Fax # 9V —.l'i �`a E -mail - - - - -- PROJECT &FORMAT ON r✓- „�'�r v Business Name /Type: Previous Business on this site: .11.,L...,z.1r ,&D-10:r `�t �tf.irF'f x� 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 that I own or have the I have readttheondit conditions of approval, and I underst nd them, and that I will abide by them provided is true and accurate to the best of my g Printed Signature APPROVAL INFORMATION [Approved with conditions [ ] Approved as proposed [ ] Backflow device and/or current test data needed for this site. Contact ACSA 977 -4511, x119. o physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing VN site plan. �� (� [ ] T / I complies wI- / he site plan S!" i rle_AC/ f `6rzd � (5,b Date Building Official Date Zoning Official Date Other Official --------------- ... - -- -- - - - -... -- --- - - -- -- •• - -• -- --- -------------- - - ........•--- •-- ....... County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 10/14/05 Page 2 of 4 Applicant to complete the following: 0/ N Do you have one of the following? Tax Map and Parcel Number and or; Address of use (include unit or floor if appropriate; lY / 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. r g Tech to com Y/ If s( ariance: o, the Intake to complete the following: Y / g? give a Itcant a Certified Is se i I, HI or PDIP zonin If so, g pp Engineer's Report (CER) packet. Y /Nr Wi re 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 l N 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 �' x.102 ✓/ 4' Y Is on public water and sewer? Y /9) Will you be putting up a new sign of any kind? If so, obtain, proper Sign permit. Permit # Yl Will. re be any new construction or renovations? If so, obtain the proper Permit. Permit # Y /'N Is this for sales of Fireworks? If so, obtain a copy of F/R permit. Permit # Prof /I IN I If SoN4=& 10/14/05 Page 3 of 4 Revie— fiver to complete the following: Square footage of Use: 221tted as: Under Section: 0, z Supplementary regulations section: Parking formula0� ` 56 s Required spaces: Y Pso Itebe verified in the field: Inspector Name & Date: Notes 10/14/05 Page 4 of 4