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HomeMy WebLinkAboutCLE200600237 Legacy Document 2014-12-02Tait map and parcel, Parcel Pa.reti. Address, COMMUNITY DEVELOPMENTI Fax 4349724126 Zoning Clearance (lnclade suite or floor) j t.'Zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS MWAN'W ©rrM© Zoning: Sep 28 2006 03:Oipm 002[0 4 W.'" City tf lv4it,avalState Zip Contact Person (,Who should we calihvrite concerning this project ?) - �o .04 P G e, � 1 tu' `1 1 I Y� r\Cf (a t-j Address _ 42 (Y� -Q_� ^-� City ` State Zip Daytime Phooe (g3gj' j "Q�J�� # f70� !�� — 1 E -mail c�b(kCiCAP. �t (YICUC i . CCJM SE CONDI;I'IONS OF APPROVAL IF IRE CLEARANCE IS FOR FIREWORK OR CB RISTMAS ;TREE SALES (Sheet 1) Circle (if applicable): Fireworks / Christmas Twee *T bis 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 pem fission 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 of Business 0 er or Agent Date Print Name e) 6k- APPROVAL INFORMATION [ ] Approvcd as proposed [ j Approved with conditions ] Backflow dcviac and/or currant test data needed for this site. Contact ACSA. 977 -4511, x119. [ l No physical site inspection has bccn done for this eleaxauce. Therefore, it is not a determination of complianer, with the existing site plan. This site complies with the site plan as of this data. Buildiatg Official - Date Zoning Official Date D Otber Official Date l) FOR OFFICE USIE ONLY CLE #i ' L C. "W Oi Fee Atnouttt $ -'-15,t7O Date Maid 9 di-O(n lay who? ern— e- _. . - , 4 Receipt 0 8252.7 Clc# � By_ County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, V,A, 22902 Voice., (434) 296 -5832 Fax: (434) 9724126 5 /1 /06 ?age2of4 Ox COMMUNITY Applicant to Complete Me Mlow>ing: Do you have one of the following? %XES ❑ NO ax Map and Parcel Number and or; Address of use (include ttnit or floor if appropriate) )?S ❑ NO o 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 amd /or; The square footage of each room or area of use; Use of caeh room or area If using less than the entire structure, note the location within the structure. ;owing Tech to c Violations: ❑YFS ❑NO If so, List: Variance: ❑ YES ❑ NO If so, List: the MENT1 Fax 434972412 ❑ YES NO Is use in LI, HI or PDIP zoning? Engineer's Report (CER) packet Sep 28 2006 03:Oipm P003/004 If so, give applicant a Certified K il ❑ NO here be food preparation? _ Ar A If so, give applicant a Health Department form. Zouing review can not begin until we receive approval fro Health Dept. FAX DAIS �'j — �ZC? -0t'0 el ❑ YES Q�NO 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 ❑ NO ill you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑ YES NO Will there be any new com9tiuction or renovations? If so, obtain the proper Permit. Permit # _ ❑ YES Is NO Is this for 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: sl06 Page 3 of 4 -7 a tv Z Z