HomeMy WebLinkAboutCLE200600271 Legacy Document 2015-01-21ti 1 Y-G-
Application for Zoning Clearance `' .
SlZoning Clearance — S35
PLEASE REVIEW ALL 3 SHEETS
PARCEL INFORMATION I
Taut Map and Parcel: 0� I W-00 `
:Parcel Owner:
,le
OFFM;E vsE OII,�r
Check# / Date: /7-(3--O(p
Receipt # %nr� Staff eB&
o 14 00 S' 7
Existing Zoning
Parcel Address:— ��ee/v�6� %ems City G ld���'state y�— Zip
_ _ jinelu ...su... or floor } ...................... -------------------- ..._---------------------------•----------
PR.l'.MARY CONTACT .. _ project? .. ���v✓�
Who should we exil/Write concerning this �I
Address ;_ " f l S� ✓�la.r� SJr �O� �Clh,. G �Cc � f vige-State Vi— Zip _2L rb L
Of ke Phone; [ () Coll #. � 11/ Fax # � Y / � E-mail
PROJECT
OR-MATI N yr-
Buslness Name/Type: �4- f1J TO (V h` A ------------------------------------
-- 6 C, - - -- fir, 3 I� �.� e liner
Previous Business on this site:
Proposed use: Q//,/-, C. i
MI.
Circle (if applicable): Fireworks / Christmas Tree
QCs G.e,a wx_
t l ci
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE 1S FOR FIREWORK OR CHRISTMAS TREE SALIrS (Sbeet 1)
'*This Clearanoe will only be valid on the parcel for which it is approved, if you change; intensity or move the use to a new location, a new Zoning
Clearance w11I be required.
I hereby certify that I own o ve own eSC.. pcunission to use the space - indioated on this application. I also certify that the information provided is
true and accurate to the bo f o I •ead the cmditions of approval, and I under hem, and that I will aide by them.
Signature Printed `'-t
ApPItOVAY. T�`�iFOR11�IATI(3N -------------- -------------------------------------- -..-------------------------------------------
[ ] Approved as proposed [ j Approved with conditions
[ j Backflow device and/or current test data needed for this site. ( :ortac:t ACSA 477-451 I, xl 19,
[ ] No physical site inspection has been done for this clearance. Therefore, it is not a determ ination of compliance with the existing
site plan.
[ ] This site complies with the site plan as of this date.
Building Official c-� _ , Date
Zoning Official Date 1 6
Other Official Date
-- --
........................... ` -- - - -- - -- -. .
County of Department of Community DevelopDevelopment •vV
401 McIntire Road'Charlottesvitie. VA 22902 Vnice: 14.341296-5932 Fax: (4341 972 -d'12! 1 n/l drfl5 Paa� )r F4
�d
e
Applicant to complete the Mowing:
k!N
``�o you have one of the followaig?
Tax Map and Parcel Number and or;
Address of use (include unit or flpor if appropriate;
`P1 ! N
o you have a Ploor 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 sgwe Footage of each room or area of use:
Use of each room or area
Ifusing less than the entire structure; note the location within the
struotum
Tech to complete the
N
. List:
N
u0
Intake to complete the following:
Y/o
Is use m Ll, HI or PD1P zoning? If so, give applicant a Certified
Engineer 3 Report (^ER) packet.
Y/9 '
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, PAX DATE
Y /1�
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
/N
Is on public water and seNver'
Y dQ
Will you be putting up a now sign of any kind? If so
proper Sign permit, rC(
Perm it #
Y /W
Will there be any new constriction or renovations? ^ n��`�
If so, obtain the proper permit. x
Permit #
Is Sr sales of Fireworks? � RrIo t' -
If so, obtain a copy of 1; /R permit.
Permit #
/Y J! N
SM 1�II -"
-0' a aX - l /1 Pra n L
4�9
�ldr•�f� i�FEENMII �
I0!14105 Page 3 of
Reviewer to complete the following:
Square footage of Use;
NON
'Perrhitte �s
d as; �- - . - - l _ ��� _
Under Section:
Supplementary regulations section: UI,
Parking formula:
Required spaces:
Y
Itent be verified in the field;
Inspector Name & Date:
Notes
I Of' 4105 Page 4 of4