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HomeMy WebLinkAboutCLE200600288 Legacy Document 2015-02-10Application for Zoning Clearance LJAZ'oning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS Tax map and parcel: 059 DO - Do- 00 " )0.3C d Existing Zoning: 4 w �r % r y --� Parcel Owner: ! Parcel Address: !�g�` (lrK )`:7,' ! City �✓���G�� * State V %/i %��� Zip 2e L1_ (include suite or floor) Contact Person (Who should we call /write concerning this project ?): eW1.z ikl Address 507 �6_ dC-� f A- City Daytime Phone f s L °�1 `��J(p Fax # (___) Business Name /Type: 1 pills 1:t:1 l- Previous Business on this site: l .� Proposed use: fn, V :5%6 %ter C C�N�Sf ill ;,y E -mail State ti's Zip GG 2 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. Signature df Business Ownd or Agent T5, W rA,1Af .Print Name f/ /0 4,;. Date APPROVAL INFORMATION 1.7* k M07' &6 ft-'MPAP:D "T AN X4(-`7 [ ] Approved as proposed [ I�pproved with conditioZ' N o Are W T'YAPs OF Imo a tt C.dvmr*r PAW' lei st sttm csWo►AKG [ ] Backflow device and/or current test data needed for this site. Contact ACSA 977 -4511, xl 19. P" H6Ph7# 4;&. 7 [ ] 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 Date C, ( J Zoning Official Date I— la— 7 Other Official Date FOR OFFICE USE ONLY CLE # ZQC& o? 9E �� -r,,, /^ Fee Amount $35,00 Date Paid {l tW-0 By who? $ (.t) Receipt #636 k# C.LC_i� i 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 R 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 com Violations: ❑ YES ff NO If so, List: Va lance: YES ❑ NO If so, List: the Intake to complete the following: ❑ YES [�j NO Is use in LI, HI or PDIP zoning? Engineer's Report (CER) packet. If so, give applicant a Certified 2--y-ES ❑ 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 p ck 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 ❑ 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 # N 0 +V-e" ❑ YES E9"N'O Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # A f O4 ❑ YES ©moo 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 [�NO If so, List: 5/1/06 Page 3 of 4 Reviewer to complete the following: Square footage of Use: ❑ YES ❑ NO 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 C1aS� i L,I WAk Td 6066 ,ER a �Ofvvo 1ncla:j TO Th i n x .0 iV1 Zarfting (C"'Jeapnee LJ,- rbai:rJg Clearance = $35 PLEASE REVIEW ALL 3 SHEETS TRY, map and pared:,-0-55 00-00- 00 -)030-0 Existing Zoning: 4 Parcel Owner- - Parcel kd.dress- :"J` c'� (�� 4� -F- t �• +� (� �� City � State �� ///�✓i't<��'� Zip ���Z (include suite or floor) p, Contact Person ('Who s.boutd we call /write concerning this project ?); P l l � %`+%�� A f(r1Sc 'y :address P"50-? kb tl� .� l`�O Q Cih, Daytime Pho ).e `141 f4_'`13 _q `f q(, Fax # L—) � _ � Fl-n'iaiI .BusiaesS Nazoe/Type: /'i )A Previous Business on this site: Proposed use: V, y State )'�' '- Zip Z2 ` :32 SEA, CONDITIONS OF APPROVAL IF THE CLEARANCE rc inn z�r.._�zinpv.n„ rn„x�•raK. � ,,,,,,., ^ . v r,, .. - Circle (if applicable): Fireworks / Christmas Tree "Thus Clearance will only be valid. on the parcel for which it is apI new Zoning Cleat-ance will be required, I hereby certify that t own or have the owner's petolission to use tt provided is- true and accurate to the hest of my lmomdedge_ l have z. abide by them. Siguatur� 6f Business Owne or Agent Print Naze Post -W' f=ax Note 7671 Date 40gBB0. To CoID pt. / V Co. .Phone•# Phone 0 Fax i Date APPROVAL INFO 21 UTZON Q-`q(,vmwsl- be pmmp�ed ow+ cen mmIxy ( J 1°,. proved as proposed OQ Approved with conditions [ ] Backflow device and/or currcot test data neodcd for this site. Contact ACSA. 977 -45 t J, x J. J 9, Xk Cc,w MKS,L zw wt c w4p f twLee [ ] No physical site inspection has.bcon. done for this cl.earanec, Tbereforc, it is not a doter nation. of compliaucc with the cxisting site plan_ [ ] Tk ?is site Complies with thr site plan as of this daic. Building Official ]date Zoiziztg Official Date Oilier Offiei.sl y.0. Date i L JQ,1 D-7 FOR OI'FICE uslE ONLY CUE # �,OG�r �� %� Fee Amount .°w79,S. -C Date Paid it x30W0 ? Sy who? j ^►ti ae,l, Receipt# k. By: . County of Albemarle Department of Community Devel.opmerit 401 Mclintive Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 5A/06 Naze z of4 ,ificaia to complete the fojl.owing: ,° y{ you knave one of the following? ❑ YES 0 NO Tax Map and Parcel Number and or; Address of use (mclu.de 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 roont or area If using less than 'the entire Sbalcft.re, note the location within the Structure, Zoning Tech to c Violations: ❑ YES / NO If so, List: variance: YES ❑ NO If so, List: ete the ❑ YES H Nu Is use in LI, HI. or PDYP zoning? Engineer's Report (CER) packet, If' so, give applicant. a Certified RYES ❑ NO Will. there be, food preparation? If so, give. applicant a Health Departnier3.t form... Zoning review cats not begin until we receive approval frot3.1 Health Aept. FAX DATE 1 / —30 —Olo ❑ YES ❑ NO Is parcel on private well and septic? If so, give applicaltt a Health Department form. Zoning review can. not begin until we, receive approval from. Health Dept.. FAX DATE ❑ "YES ❑ NO Is on public eater and sewer? ❑ YES ❑ NO Will you be putting up a neuw sign of any kind? If so, obtain Proper Sign permit. Permit # ❑ YES B-'NO Will there be, any new construction or..reitovations? If so, obtain the proper Permit. Permit # // Q ❑ YES Q''r0 Is this for sales of Fireworks? If so, obtain, a copy of J~/R permit. Permit # Proffer. s: [I YES [NO If so, List: -- ❑ YLS [-NO If so, List: 511106 Pagc 3 of 4-