HomeMy WebLinkAboutCLE200600229 Legacy Document 2014-10-03Application for_�'ya�
Zoning Clearance
jl�oning Clearance = $35 40,
PLEASE REVIEW ALL 3 SHEETS
Tax map and parcel , Av >lt �� Existing Zoning:
Parcel Owner:
l }
Parcel Address: 2 �� 3 > J' e7 `�iC. M City e Y> Jf ci State A a ZipGz,/.#
(include suit or floor)
Contact Person (Who should we call /write concerning this project ?): ��' ✓ / =J� 42z _1J__.
j >
Address A y� !1'/'i �e 241 , City � 7�l /f� J State 1 _ Zip
Daytime Phone �L —/7�� cl Fax # L__) y, E -mail `'t 264l f) y'J ) n —f � lJar a m
Business Name /Type: e! �X ee,O"e.-C,
Previous Business on this site:
use:
tNL `i'Y4� U A
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR
Circle (if applicable): Fireworks / Christmas Tree
,: IA.a /� I P4 - Gr, S,
.y M J/C
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 th%�
Signature of usiness Owner or Agent Date
Print Name
APPROVAL INFORMATION
[ ] Approved as proposed [ ] Approved with conditions _
[ ] 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, ` -
�[fC Dihvh ,
Building Official
Date
Zoning Official
Date
Other Official
Date
FOR OFFICE USE n ONLY CLE # �2C0& - c_2a9 �,I� //q �� , % /�
Fee Amount $&'1 , .., Date Paid —2 %-C� By who? ' '�Q_!((lo Receipt #TCk# / 7 By:
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 5/1/06 Page 2 of4
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)
2/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.
Y,V 4eer,
Zoning Tech to c
Violations:
❑ YES ❑ NO
If so, List:
Variance:
❑ YES ❑ NO
If so, List:
the
Intake to complet the following:
❑ YES O
Is use in LI, HI or PDI oning? If so, give applicant a Certified
Engineer's Report R) packet.
❑ YES NO
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
R- 'ES ❑ NO
Is parcel on private well adG@ ' f" 1 V'OL1tQ
If so, give applicant a Health Department form.
Zoning review can not begin until we receive appro�from '\
Health Dept. FAX DATE
[AYES ❑ NO
Is on publi at and sewer?
❑ YES 'br "'v
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
❑ YES 4< 4
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
❑ YES NO
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
❑ YES ❑ NO
If so, List:
SP's:
❑ YES ❑ NO
If so, Li V/
fl -�
5/1/06 Page 3 of 4
Reviewer to complete the following,
Squa`r'e footage of Use:
E�/4'ES ❑ NQ
Permitted as:
Under Section:
Supplementary regulations sec W (ttion:
Parking formula: 1 -J �ti td. —
Required spaces: F3
❑ YES ❑ NO
Items to be verified in the
Inspector Name & Date:
Notes
5/1/06 Page 4 of 4