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HomeMy WebLinkAboutCLE200600264 Legacy Document 2015-01-21Anblication for N ; ?' "`r Zoning Clearance ,N,a 12/zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS Tax map and parcel: 0,5 4 A 2 -01-00 °- 02-100 Existing Zoning: Parcel C,roze-r- shoPptn Ce►� t r Parcel Address: S92!? Th yiee f-l:h v rsc�d City �Yoz �° Y' State VA Zip Z.2 qga (include suite or floor) p ( ( / Contact Person (Who should we call /write concerning this project ?): 1V -1 I �y� CL`a U!? Address Q[ I YY1 ea J L-.a VI e_ City f la r o t-r q vi I I C- State �_ Zip 2 z 56 1 Daytime Phone Fax # E -mail Business Name /Type: W,�9yf1e-�5'b0J'0;Vfi 22 Previous Business on this site: Proposed use: o 12/24/ ©6 SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet 1) Circle (if applicable): Fireworks / CC,hristm— as T ee *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 them. C If ! // log Signature of Business Ow or Agent Date , AICI.I., Print Name APPROVAL INFORMATION [ ] Approved as proposed [ ''W"AApproved with conditions ] Backflow device and /or current test data needed for this site. Contact ACSA 97.7 -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 corn � s w�tlhthe,ite plan as of this date. Building Official Zoning Official Other QfU A% Date i l 0 6 Date Date _L143 �70 FOR OFFICE USE ONLY CLE # 4=/ �+ Fee Amount $'Z nn Date Paid (Z 0 By who? lA L _ Receipt # A6qD Ck #Fq 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) ❑ 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. I ,oninjj Tech to c Vi ations: YES ❑ NO If so, List: S Variance: ❑ YES ❑ NO If so, List: the Intake to complete the following: ❑ YES ❑ NO Is use in LI, HI or PDIP zoning? Engineer's Report (CER) packet. If so, give applicant a Certified ❑ 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 ❑ 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 Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑ YES ❑ 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 ❑ NO If so, List: 5/1/06 Page 3 oP4 Reviewer to complete the following: Square footage of Use: [YES ❑ NO Permitted as: � n Under Section: Supplementary regulations section: Id 1 a Parking formula: 1(� 41/I nn Required spaces: 1, ;lG ❑ YES F� NO Items to be verified in the field: Inspector Name & Date: Notes 5/1/06 Page 4 of