HomeMy WebLinkAboutCLE200600260 Legacy Document 2015-01-21� e • n rs • /V 7 U � \ .
Ap plication l ®r L®ning uiearance
OFFICE USE ONLY
Zoning Clearance = $35 CLE #
PLEA PE REVIEW ALL 3 SHEETS Check # Date:
Receipt # Staff:
PARCEL INFORMATION
Tax Map and Parcel:
Parcel Owner: JY-,6
cis -60 dD - 00 — 0 6�) a134 Existing Zoning 0,
U1
kAO,
nn J
Parcel Address: ��0� r / � Kou, City Ile, State Vim—' Zip
(include suite or floor) ----------------------------------------------------------------
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APPLICANT INFORMATION C�L
Who should we call /write concerning this project? f ,�(� l
Address: 9 &0 �1k1 Z 1�%5- � • City 1��l1 YJ� Y CVI /16State Zip �a90/
Office Phone: (U 77--7- 151 Cell #
Fax #
E -mail 0-ZO e&g J6/JC-k�6?1AS, a/)-,
-
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Business Name /Type: �- -
PRIMARY CONTACT 06711-1 �� ��,�LU�'7 I� elO - %� chtw- (
Previous Business on this site: ?211-
Proposed use: —69 k-/Y
Circle (if applicable): Fireworks / Christmas Tree
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 %e. ave the owner's permission to use the space indicated on this application. I also certify that the information provided is
true and my o le ge. I /Wave read the conditions of approval, and I understand them, and that I will abide by them.
Signatu Printed am 094��
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APPROVAL INF-- ORMATION
[ ] Approved as proposed [I/] Approved with conditions
[ ] 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 conytplies w,ith„the site plan as of this date.
Building Official �— Date — o
Zoning Official Date d 12l lO&
Other Official
Date
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County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
A pllicanL to 1:V111pketG 1112 1V11V 11111•
Do you ha/onee e foll owing?
F-1 YES
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate)
YES ❑ 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 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.
Vu
y
'S oning Tech to comp ete the following:
VF'lations:
YES ❑ NO
so List-
'26 �e— A; � K911
Variance:
r_] YES NO
If so, List:
Intake to complete the following:
❑ YES E�f NO
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Rep it (CER) 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
❑ YES E' 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
[11YES ❑ NO
Is on public water and sewer?
❑ YES ['NO
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
❑ YES WNO
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
❑ YES WNO
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
❑ YES NO
If so, List:
❑ YES ❑ NO
If so, List:
b 6
—�
d
5/1/06 Page 3 of 4
Reviewer to complete the following;
Square footage of Use:
BYES ❑ N n ,--
Permitted as:
Under Section: A Ayprz ✓aC
Supplementary regulations section: _Ion rc",
Parking formula:
Required spaces: Lol —
❑ YES ❑ NO
Items to be verified in the field:
Inspector Name & Date:
Notes
5/1/06 Page 4 of 4