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HomeMy WebLinkAboutCLE200600276 Legacy Document 2015-02-10Application for 66-2-V Zoning CleXance LLoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS Tax map and parcel: (� "�� Qd V ©� ��aQ Existing Zoning: Parcel Owner: T�-)(,)r1 4^ e) .:ek . I'�RCIN�P Parcel Address: n n o 'br —city �Y �`�'i &Q State V) P" 1 v'i.(Atu Zip (include suite or floor) ll - Contact Person (Who should we call /write concerning this project ?): �L� . �n ,P. r��l'J� J K Address J"( �� l S4 (� I V�2'�,� --�5 J2i� City �� n State J Zip 030 Phone (�') &22.- __?Q00 Fax # (! o_X l(P E -mail Business Name /Type: —/ 'Y.- Previous Business on this site: Proposed use: 4'c..�k 44 Le_p <',—k C) 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. [1,-f 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 i a l Date _ Q Date FOR OFFICE USE ONLY CLEI# Z ( 1910— a-740 Fee Amount $.35, 0' Date Paid 11-11-,00 By who. (L/ Receipt Ck# 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 z of4 Applicant to complete the following: Do you have one of the following? /K YES ❑ NO Tax Map and Parcel Number and or; Address of use (include unit or floor if appropriate) YES ❑ NO , D`oyou 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. coning Tech to complete the following: Intake to complete the following: ❑ YES 0%rvU Is use in LI, HI or PDIP zoning? Engineer's Report (CER) packet. If so, give applicant a Certified ❑ YES LQ 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 %V NO Is parcel oiiprivate 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 9 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 # Id. YES ❑ NO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # 2o(5(a(i -2Z%2 ❑ YES c2- NO Is this for sales of Fireworks? If so, obtain a copy of F/R permit. Permit # Vio ions: fers: Z Y Pr ES ❑ NO YES ❑ NO If so, List: If so, List: CnO Variance: ❑ YES iNO If so, List: [Vj YES NO If so, List: 5/1/06 Page 3 of Reviewer to complete the following: Square footage of Use: ❑ YES ❑ NO Permitted as: Under Section: Z Gy !� .Z%Z .2"1l 1 I Supplementary regulations section: A ' Parking formula: Required spaces: ❑ YES ❑ NO Items to be verified in the field: Inspector Name & Date: Notes 5/1/06 Page 4 of