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HomeMy WebLinkAboutCLE200600274 Legacy Document 2015-01-21Annliratinn fnr Zoning Clearance 2 ,�Oh nl.g�l U� � iltc�N�n I V-0 2� fi oning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS Tax map and parcel: V ®� G✓ _. C (,I X91 ing Zoning: Parcel Owner: !—,{� l� r 1 y C -f—A 4--L Parcel Address: rhree. 1V© rck)&R6- L' ro-zo + State Vol, Zi � (include suite or floor) ff Contact Person (Who should we call /write concerning this project ?): a `� l i A7 S Address ` 0 13 C) /` b � 6 4,& City t 6 e L2 / State V A Zip:299 0 Daytime Phone " �6 ®t' Fax # (_� E -mail Business Name /Type: Previous Business on this site: Proposed use: G> "�� !� f �� 9 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 them. I% h L � C) C- Date 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. ] This site complies with the site plan as of this date. Building Official Zoning Official Other Official Date Date FOR OFFICE USE ONLY CLE # Gi ' -7 '] Fee Amount Qc) Date Paid 1 i- l6-ft By who? .S'/. i�QG.S.r i eceipt # 6;789 °/p Ck# / —T 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. , oning Tech to c Violations: ❑ YES aNO If so, List: Variance: ❑ YES .❑ NO If so, List: the 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. ❑ 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 01U 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 *ES El No I public water and sewer? Vol ES Will you be Tufting up a new sign of any kind? If so, obtain proper Sign. ermit. Permit # f s 7— 6 049 10? T ❑ YES [ErNO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # ❑ YES 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 D,40 If so, List: 5/1/06 Page 3 of -Reviewer to complete the following: Square footage of Use: ES ❑ N Permitted as: Under Section: Supplementary regulations section: �- Parking formula: Required spaces: ❑ YES ❑ NO Items to be verified in the field: Inspector Name & Date: Notes 5/1/06 Page 4 of