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HomeMy WebLinkAboutCLE200600250 Legacy Document 2014-12-02Application for j Zoning Clearance +'Zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS pY AL$vi ,1 tppiN�P Tax map and parcel: (,) (0 (t�d 0- 66 -- 13 J 19�-D Existing Zoning: U"° OSQ Parcel Owner: . i W JA-un- Parcel Address: 1600 RL) 1:2. � )` b5ai City 0h1Ar`D -#ES ✓;_ Ile. State VA Zip aD-901 (include suite or floor) Contact Person (Who should we call /write concerning this project ?): r© (Angl Address '734 R71s 6%1 C�'c' -��C .� City e r)orJo v State Zip Daq L I Daytime Phone Fax # (_) E -mail assrA 06 r8 P hat ►no: , l ° Go nti Business Name /Type: + J -su /6 -_s,0j1dc& L7- Previous Business on this site: Proposed use: SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet 1) Circle (if applicable): Fireworks / Christmas Tree *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 ;abid by them. 1o16)9 lo6 Sign Preof Business Owner or Agent Date _ Of l l'1G1 5 Le Print Name I A t 1.1 APPROVAL INFORMATION [ ] Approved as proposed [ ] Approved with conditions ] Backflow device and /or current test data needed for this site. Contact ACSA 977 -4511, xl 19. ] 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 Other Official Date FOR OFFICE USE ONLY CLE # ZD0i -2,60 Fee Amount. $J`�10C� Date Paid jL,`�La °I���By who? �l.ri l.9 ? Receipt # 4JC?��� Ck# �( 'i?J n By: County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 5/l/06 Page 2 of4 Applicant to complete the following: Do you have one of the following? ❑ YES ❑ TNO Tax Map and Parcel Number and or; Address of use (include unit or floor if appropriate) ❑ 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. Din v) 10 C-t x I a- C' Pt I3AcK room b4-4 squw -e, j�-k 0 to 4o Zoning Tech to c Violations: ❑ YES ❑ NO If so, List: Variance: ❑ YES ❑ NO If so, List: the followin Intake to complete, the following: F-1 YES FV4' Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. ES ❑ NO Will there be food preparation? If so, give applicant a Health Department form. Zoning review can not begin until we receive ap val from Health Dept. FAX DATE / -- to ❑ YES [�KO Is 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 YES ❑ NO Is on public water and sewer? ❑ YES TO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑ YES [j-,N'0 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, List: 5/1/06 Page 3 of