HomeMy WebLinkAboutCLE200600268 Legacy Document 2015-01-21AplcaC'on for Zoning CXea�rance
❑ Zoniug Clearance = S35 OFFICE USE ONLY ,
CI,E # zoa� -- '?7�
PLEASE REVIEW ALL 3 SHEETS Check # Date: J
Receipt # gaff;
PARCEL INFORMATION
Tax Map and Parcel: 6 T I -3 Existing zoninK :5 (t
Parcel Owner ,.' ` S Po PP; IV G C c N I t A so C C/o
ill D Al -A BA�To(�o
Parcel Address-.- ��r7O L- 071-0 city Cifi4R /oi'�Eyy' lie State V' T zip 2Zq'o )
(include suite or floor)_
--------------------------------------------- ---------------------
Y CONTACT _
Who should we call/write concerning this project' P % f )Q-S M CL (,/+S -H
Address; 9)1t Go bcjeh CodgT -ol- l city -t-5 State
V/ zip �2a 1o7
Office Phone: C s 13 I Cell # iro 3 2 S-S. Fax # E -mail 's(o S tr p
- ....... - -................... -........ ......... ....------ .., -------- .... - - -
PI2.OJECT INk'ORMATION _ -------------- ------- - - - - -- -_•.........................
Business Name/Type, - Q- C'N -T 'P 2 1_S E / j C tE K\ S —[ M ft S -T R 18 E S
Previous Business on this site: R S t � o S 9' ;} t4 kl
Proposed use: G W R• t
Circle (if applicable): Fireworks / hristmas 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 requittd,
I hereby certify that l own or have the owners permission to use the space indicated on this application. 1 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 -I- Printed yo S k P.14 14_C M E L L,fl 5,4
A-PPROVAL INFORMATION ........ , ... ................................. ............... ....... ......
Approved as proposed [ ] Approved with conditions
[/ ] Backflow device and/or current test data needed for this site, Contact ACSA 977 -4511, x 119.
[ J 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
Zoning Official
Date (� f ZI ( 0 �
Date _ //• 2/ -47 G
_$9�4hot' Official r"��`� Date
-------------------_-
-----------...-,--- of Albema-----•--------------•-•----------•---------•--••-----------I._...... ...
Albemarle Department of Community Development
401,Mclutire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Pax- (434).972-4126 1
4 10S Page 2 of 4
900 in aamn v nia -ainv CZTb ZL6 bCb xva 9c :2T 9002 /TZ /TT
.Application for Zoning Clearance l ,
OFFICE USE ONLY ;
F] Zoning Clearance = $35 CLE # Z ® ®(o
PLEASE REVIEW ALL 3 SHEETS Check # Date:
Receipt # Staff:
PARCEL INFORMATION p
Tax Map and Parcel: r / ` 3
Existing Zoning / —Sc
Parcel Owner: o %ai l /1% �i o C/a -�-% n o lv -pervi rT011O
Parcel Address:
1600 L. 91"o o City Z'WR O- H— CYV�Ile State V )t- Zip 2Zcfro )
(include suite or floor) -------•----------------------------------------
PRIMARY CONTACT
Who should we call1write concerning this project, y c�
Address: g� i Ca la �! e h coo I f . i City M 4NA-S 5 � State 1� /1 Zip c^,,Q a 1 o
Office Phone: &3) �5 �3 i3 � Cell # 3" Z5" -SnCf Fax # ? "L �`t`i -�M 2� E -mail 1/0 5 i P tE .— %� � K5 -ah
PROJECT INFORMATION
Business Name/Type: 8' t N Z S L /
Previous Business on this site: F(A S )A 1 U K e-
Proposed use: c% R S -'C K 19- 5 ('=' Z E S
L 1"AI rI ujlpl- 3-m.,-- -a dw
Circle (if applicable): Fireworks / hristmas 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 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.
Signature 4 Printed v� 5 to % 15 �-' S
---• ............... .........•-•--... - - - - --
APPROVAL INFORMATION
[ ] Approved as proposed [ ] Approved with conditions
[ ] Backflow device and/or current test data needed for this site. Contact ACSA 977 -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.
[ J This site complies with the site plan as of this date.
Building Official
Date .-
Zoning Official Date
r- Official
Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 10/14/05 Page 2 of 4
Apviicai9t to complete the following:
Y/N
Do you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
�/ N
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.
Zoning Tech to complete the following:
Violations:
Y/N
If so, List:
Variance:
Y/N
If so, List:
Intake to complete the following:
YC21, Is HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y
Wi ere 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
Y
Is el 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
Y
on public water and sewer?
Y/N
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit # Sz f
Y —/'7 /
W re be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Y
Is t ' or sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
Y/N
If so, List:
SP's:
Y/N
If so, List:
10/14/05 Page 3 of 4