HomeMy WebLinkAboutCLE200600280 Legacy Document 2015-02-10Application for Zoning Clearance _ w
OFFICE USE ONLY �y
CLE# r-2-0�
Zoning Clearance = $35 Check # 7 2. Date: -
PLEASE REVIEW ALL 4 SHEETS Receipt # _ toa q,3 6? Staff:
PARCEL INFORMATION o�
Tax Map and Parcel: 45117 Existing Zoning A�
Parcel Owner: PT @" )N L A L
Parcel Address: Li 10 N be-ma -A.-- Sl� - City (2 t'► IliNL State 0 Zip 22-9 OZ.
(include suite or floor)_ - - -- -
APPLICANT INFORMATION
Who should we call /write concerning this project? �b1OrD,l�
Address:?-t, 130K 116 Y3 City G' ke.'{e-E*su' lam- State 0 Zip ZZ.902-
Office Phone: 3i ) 91 Z-11 FrC Cell # Fax# y3`i —SP2 34 E -mail
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PROJECT INFORMATION /�
Business Name /Type: /"� L L
Previous Business on this site: N 114
Proposed use: McX1'%cc-A Ott 'LA- y►G4nct 61*n4_
Circle (if applicable): Fireworks / Christmas 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 /��, Printed✓
APPROVAL INFORMATION
( ) Approved as proposed ( ) Approved with conditions
Building Official Date C.
Zoning Official Date 12, 1/0(,
Other Official Date
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County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
3/28/05 Page 2 of 4
Applicant to complete the following:
C N
o 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? V,- Kc -c,,a.d
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.
I -2—CJ S%. -C'
M
Tech to complete the
Violations:
Y/N
If so, List:
0o
FOR
WOMmt - I
RIUMMMZR/f►I off► ..
Intake to complete the following:
Y/N
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y/N
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
Y/N
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
Y/N
Is 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 #
Y/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Y/N
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffe s:
If Mist:
Ifs
SP's:
Y/N
If so List:
-M (hNnkmf Q,
3/28/05 Page 3 of 4
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 ❑ NO
Is parcel on private well or public water?
If private well, provide Health Department form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
❑ YES ❑ NO
Is parcel on septic or public sewer?
❑ YES ❑ NO
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
❑ YES ❑ NO
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning Tech to comDlete the following:
Reviewer to complete the following: /
Square footage of Use: { -4-06
9 YES ❑ NO
Permitted as: IAP
Under Section: i a�� �, v • o`�
Supplementary regulations ection:
Parking formula:
Required spaces: � I I Affllw& y
❑ YES ❑YES N6 I
Items to be verified in the field:
Inspector :
Notes:
Violations: Proffers:
❑ YES ❑ ❑ YES F1 NO
If so, List: If so, List:
Variance: 's:
❑ YES ❑ NO ❑ YES ❑
If so, List: If so, List: 7Z
Date:
511106 Page 3 of 3
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