HomeMy WebLinkAboutCLE200600213 Legacy Document 2014-10-03`� V ��Jil'lllll_r�G
Application for Zoning Clearance '1 � O� �1 - 0lp
10 -31, 0
OFFICE USE ONLY
a Zoning Clearance = $35 CLE # _ ZI�O��-' y 3
PLEASE REVIEW ALL 3 SHEETS Check # O l Date:
Receipt # In i to 4 U Staff:
PARCEL INF M�Tji
�a %D �� `O ` Existing Zonin
Tax Map and Parcel:
Parcel Owner: S/ n P 1rJ N c c�E� 6150C.... J/0
Parcel
Parcel Address:! % �0 City
) (� it i t(' State V Zip
(include suite or floor)----------------•--------------------•------------------•-----------------------------------
---------- •----- - - - - -- -- - ----- - - - - -- - -- - --
PRIMARY CONTACT 9 }/d _S C r B ,A� �-C. !S �'I
Who should we call/ `write concerning this project. ff j
Address
C 1 (�e b C� 1 h OUWT City tJ A rA10-S5t3S State V A. Zip Za 1'a cl
Office Phone: (� - + � 5— X31 Cell # 2:4 Z ��I� Fax # °7c�1`3 `� `i -'4076E-mail
PROJECT INFORMATION _ p i
Business Name/Type: � � t✓ � .T e; � � � � S t'
Previous Business on this site: FE'S' `ak % r, N 9 "1 iA LL
Proposed use:
Circle (if applicable): Fireworks / Christmas Tree
1✓
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.
Signature
`-�— Printed m
----- - - - - --
APPROVAL INFORMATION [ ] Approved with conditions
[ ] Approved as proposed
[ ] Backflow device and/or current test data needed for this site. Contact ACSA 977 -4511, x119.
[ ] 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.
Building Official Date
Zoning Official
Date 9 �
Other Official Date
...................................... ... ....... . . . . .. ..••---•-------•------------------------------•---•--•---••----•-------.•-
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
r.
Xliplticant to complete the following:
o
o N
you have one of the following?
Tax Map and Parcel Number and or;
Mress of use (include unit or floor if appropriate;
N
ou 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 followin
Viol q "'ns:
Y /
If so, Est:
Vari, ce:
Y /(NJ
If so, ist:
Intake to com lete the following:
Y C,), Is l, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y
Will ere 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
Is IN
Is p el 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 asr:?7
V Y/N
on public water a
1' /N
ill you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit# %--5 006--79
-y
Y / /..S ZOO&-79 !/
Wilre be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Y
Is t or sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Pro .
Y N
If so, ist:
SP's
Y /NIf so, ist:
P LC rn P I CL,-f✓
10/14/05 Page 3 of 4
Reviewer to complete the followi „O D
5quare`footage of Use: ' f��
e N
itted as:
` V�Under Section: �
Supplementary regulations section:
Parking formula:
Required spaces: iQ�G
Y/N
Items to be verified in the field:
Inspector Name & Date:
Notes
10114105 Page 4 of 4