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HomeMy WebLinkAboutCLE200600290 Legacy Document 2015-02-10Application for Zoning Clearance ❑ Zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS Ui i /RGIN�P Tax map and parcel: NQ UL I `03 -w - = Existing Zoning: Co4y rew- Cl 4 Parcel Owner: U V+ - y- Parcel Address: l3o 5 S �,im�n o�� t i 1 City l/ 0 (v I► e� �J 1&— State U - Zip 2 2q(9 (include suite or floor) j(� Contact Person (Who should we call /write concerning this project ?): IV U �U - T r Address 00a Rerknga r Ic) G y^1y'e' City ar a �5 v & State V A Zip z 2 �� i � Daytime Phone cqj$ 6 -3361 Fax # (� IT-71 --739q E -mail Business Name /Type: 11 J ./ Val Iwwor INS Previous Business one this site: -59'S -5 i` S I C Proposed use: OR C. 5w Ge 7W IV; 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. 4 - )2 ©sob Si natur o usi ess ne r or Agent Date Ph"I �G(Gel Print Name APPROVAL INFORMATION [ 0 Approved as proposed [i'] Backflow device and /or current test data needed for this site. [Vf No physical site inspection has been done for this clearance. [ ] This site complies with the site plan as of this date. ] Approved with conditions Contact ACSA 977 -4511, x119. Therefore, it is not a determination of compliance with the existing site plan. Building Official Date I 1 0 Zoning Official Date J?J o 6 Other Official Date FOR OF S NLY Fee Amount nt $L5.dL Date Paid C # *4LBy who? { — M401-tv - Receipt #,-� j- t 10$g By: -' - -Ck# 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 Applicant to CoMnlafia the fnllowina 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) "S ❑ 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. Tech to complete the Violations: [2/ YES ❑ NO If so, List: F-1 YES n • 00, Intake to compete the following: ❑ YES t%NO ve Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. ❑ YES LsJ/O 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 E1GO 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 ;1Z d sewer? F1 YES Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑ YES 2141110 Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # ❑ YES [INO Is this for sales of Fireworks? If so, obtain a copy of F/R permit. Permit # Proffers: ❑ YES NO If so, List: FYES ' ❑ NO If so, List: -L`� _1P 5/1/06 Page 3 of 4 Reviewer to complete the following- Squard footage of Use: YES ❑ NO Permitted as: 5` okTimci Under Section: l t.--6 l 1 ) Supplementary regulations section: A Parking formula: Required spaces: ❑ YES ENO Items to be verified in the field: Inspector Name & Date: Notes 5/1/06 Page 4 of 4