HomeMy WebLinkAboutCLE200600239 Legacy Document 2014-12-02r Application for vG X39
Zoning C earance
NV�1 CIN�P
Zoning Clearance = $35 r -e a ck
PLEASE REVIEW ALL 3 SHEETS
L4 L4- 95 e
Tax map and parcel: + ( �2 Existing Zoning: ✓
Parcel Owner: ple lm'(5, V i`�Q1t1Rl� fi t, a� 1. dlere
Parcel Address: 1g, (DQ -ll.re City C11d. ,e State UA Zip
(include suite or floor)
Contact Person (Who should we call /write concerning this project ?):
Address 6n?- .Sr�IWI. 1" l City ( t'A� P State //UP Zip
Daytime Phone 1'f p 6r - Fax # L� E -mail C'�_�`I R4U� U 6+VVQO) L C. ov. .
9(01 - -539a
Business Name /Type: L rH e—) tk,\n J "��✓ iD Q� �J C,�' � SS &V,
Previous Business on this site:
���vv`t`E?l�- C'D2rOtr��tnv --
Proposed use: � e c 1 / r,I .'A SP Lt
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
abide by ther#1 , . , _ J{
I V -)G � o,
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SignatureolIf usinLes wner or Agent Date
Print Name
AVROVAL INFORMATION
V4 A proved as proposed
[ ackflow device and /or current test data needed for this site.
[ No physical site inspection has been done for this clearance.
[ ] This site complies with the site plan as of this date.
] Approved with conditions
Contact ACSA 977 -4511, x119.
Therefore, it is not a determination of compliance with the existing site plan.
Building Official Date (� C I c (,
Zoning Official Date I 17- duo
Other Official Date
FOR OFFICE USE ONLY CLE # 7—QC74p "1 Z3 q
Fee Amount $ C 0 Date Paid 10-2 -Od) By who? Si. R gel q. Receipt # 69,743 Ck #s 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
01-7a -9310
`kp;licant 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)
❑ YES NO
Do you halfeN 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.
S c� f'�-a -/-a �. /-C7
cjp0
Zonina Tech to complete the
Violations:
❑ YES Lj NO
If so, List:
Variance:
❑ YES NO
If so, List:
Intake to complete the following:
❑ YES ❑ NO
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
.L YES ❑ NO
Will there be food preparation? v
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from
Health Dept. FAX DATE —Z -Oa l/1- a
❑ YES ❑ 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
VHealth ept. FAX DATE
❑ NO
Is on public water and sewr
❑ YES V� NO
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
❑ YES N NO
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
If so, List:
511106 Page 3 of
tgiewer to complete the followSn�g:(' ?
Square footage of Use:
YES ❑ NO
Permitted as:
Under Section:
Supplementary regulatio section:
Parking formula: 11VT01 %
Required spaces: v G�
❑ YES ❑ NO
Items to be verified in the field:
Inspector Name & Date:
Notes
5/1/06 Page 4 or