HomeMy WebLinkAboutCLE200600278 Legacy Document 2015-02-10Application
Zoning Clear
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1 -1 Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
Tax map and parcel: Oto o 1 Q Q - a 8 - 00700 Existing Zoning:
Parcel Owner: l k A J%_W_X Y r 1.. 1
Parcel Address: �{C/0 P-U"A +kao—a4llp City
(include suite or floor)
Contact Person (Who should we call /write concerning this project ?): _
Address 491, S' City _d1_1147lez.
Daytime Phone &3y) 3y) c? '�-3'-f{A f j Fax # y(1) 3 - \ q E -mail
Business Name /Type:
Previous Business on this site:
Proposed use:
7- - ACC `'r /A W "� 1 -PAR Je
. -
State l0 a. Zio 794
'k- IA/A W
Vlll&— State VIA- Zip �iI p
7S 4—P -- mte_ ' %R# st%r,&-r &,<-X_ I AW_
7 s lio4a
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. / tA�_
Signature of es
Bu ' s Owner or Agent Date -
Print Name
APPROVAL INFORMATION
Approved as proposed
([ �] Backflow device and/or current test data needed for this site.
[ ] No physical site inspection has been done for this clearance.
[ ] This site complies with the site plan as of this date.
Building Official
Zoning Official
Other Official
] Approved with conditions
Contact ACSA 977 -4511, x119.
Therefore, it is not a determination of compliance with the existing site plan.
i D, t
�i Date
FOR OFFICE USE ONLY CLE # _,nb 3 7 E 415MOIgls
Fee Amount $ pp Date Paid t Z - . 'By who? kt H hel _e3ff�l Receipt # (oa%o Q 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 2 of 4
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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)
HI 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.
Zoning Tech to c
Violations:
❑ YES [-x NO
If so, List:
Variance:
❑ YES 191NO
If so, List:
the
Intake to complet the following:
0 YES 0
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
[Er /YES YES 0 NO o'4D + ot O'' `
Will there be food preparation? ez�
If so, give applicant a Health Department form.
Zoning review can not begin un it e receive approval from
Health Dept. FAX DATE
❑ YES [r 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
DYES ❑ NO
Is on public water and sewer?
❑ YES 2/NO
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
❑ YES 5;,ND
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
❑ YES -_ 0
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
❑ YES 211NO
If so, List:
SP's:
❑ YES NO
If so, List:
5/1/06 Page 3 of 4
T_eviewpr to complete the follbwino:
Square footage of Use: P✓
YES ❑ NO
Permitted as:
Under Section: — A,
Supplementary regulations section: UU \U\
Parking formula: ab0 aZx
Required spaces:
❑ YES
Items to be verified in the field:
Inspector Name & Date:
Notes
5/1/06 Page 4 of