HomeMy WebLinkAboutCLE200600289 Legacy Document 2015-02-10Application for
Zoning 9earance
'Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
Tax map and parcel: t:✓ (� �(J ° / �" Existing Zoning:
Jo's
Parcel Owner: �� /I r� Yq�' �� 1� \U�`a ; �!" �<5 j
Parcel Address4 -{'> blwmz, 4b�a e, City C.(-4¢'t'f� l(EWLQ- State �� Zip 2� D
(include suite or floor)
Contact Person (Who should we call /write concerning this project?):
Address 3?-6) 0644 -Pt— 4 wei City� State VA- Zip
Daytime Phone% ,761Q- Fax # 0(e';' E- mail/ / (.. ��Y�SC�N�iel4er(�
Business Name /Type: G�(44Wt,0 1AeX j
Z'
Previous Business on this site:
Proposed use: &, CGaY CLC f I L(- AAf,'OlCla-L_ rt7�,A'b � F }�/kL C i r��S� K� r��!✓
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 oty knowledge. I have read the conditions of approval, and I understand them, and that I will
abide0v them. i //
G �2 5�Abl'
or Aizent Date
Print Name
APPROVAL INFORMATION
[ t]Approved as proposed
[ ] Approved with conditions
L�ackflow device and /or current test data needed for this site. Contact ACSA 977 -4511, xl 19.
No physical site inspection has been done for this clearance. Therefore, it is not a detennination of compliance with the existing site plan.
[ ] This site complies with the site plan as of this date.
Building Official �^ Date
Zoning Official Date;
Other Official Date
FOR OFFICE USE ONLY CLE # Z CO `° 6
Fee Amount $25,,100 Date Paid !,'a -6- p /FBy who? (?, ,6 i Aje' Mg-Xi Receipt # �� —Ck# /Ooh7 By: XG
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
lig'iplic,.ant t^ c^m p. le fp ±hp fnllo- wing;
Do you have one of the following?
❑ YES ❑ NO
Tax Map and -arcel Number and or;
Address 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.
/ 80C3
Tech to complete the
Violations:
❑ YES ❑ NO
If so, List:
Variance:
❑ YES ❑ NO
If so, List:
Intake to complete the following:
❑ YES PR-1�0
Is use in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
❑ YES QNo,*,
If so, give applicant a Certified
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 Liu
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
ES ❑ NO
Is on public water and sewer?
S ❑ NO
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
❑ YES 0
Will there be any new construction or renovations?
If so, obtain he oper Per I I2--A-C
Permit # U,
❑ YES LNO
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: 1S ()O
YES ❑ NO
Permitted as: j- ( ✓y �2 j o id. Cc,
Under Section: �j� • o� �� ��
Supplementary regulations section:ti I a
Parking formula:
Required spaces:
❑ YES i NO
Items to be verified in the field:
Inspector Name & Date:
Notes
5/1/06 Page 4 of 4