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HomeMy WebLinkAboutCLE200600291 Legacy Document 2015-02-10Application for Zoning Clearance [5'Zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS Tax map and parcel: 64 � P,4­00-00 ­0i000 Existing Zoning: Parcel Owner: Fc-t?rAivr I!RCIN�P Parcel Address: City C ,. sa U= ' sf i State \(gy Zip 22-3 0I (include suite or floor) Contact Person (Who should we call /write concerning this project ?): �� GY3� 'loLA')AA.%5- /Ats.._Sryt_ P 1 A Address lk 0 L CA- City PA., mlran. State VA- Zip Z2�1(r3 Daytime Phone LJrfl -�b1.S Fax # E -mail (-t t3� Q ALLF,AV& f-( • C09 Business Name /Type: T-C C. 12ULIP b,3A LIE.:r -G-x ��v`Ice Previous Business on this site:Or�Gata� Proposed use: —f sumvg- , 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. I I /is 0", Signature of Business Owner or Agent Date LI E5,y C—cx2 �uC�t -1 Print Name APPROVAL INFORMATION [ ] Approved as proposed ] Approved with conditions [ �Backflow device and /or current test data needed for this site. Contact ACSA 977 -4511, x119. [ ] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance ] This site complies with the site plan as of this date. Backtlow Device and/or Current Test Data Needed Contact ACSA 977 -4511, x 119 w�the existing site plan. Building Official Date .A 0 C3 Zoning Official Date Other Official Date FOR OFFICE USE ONLY CLE # � 001P 0 Da %1 "25113 Fee Amowit $ 4- Date Paid By who? 7, ipt # !� Ck #5a0C) By: E� r 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 'Appl:-ant- to complete the following: Do you have one of the following? ZYES ❑ NO Tax Map and Parcel Number and or; Address of use (include unit or floor if appropriate) [BYES ❑ 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. Zoniniz Tech- to complete the Violations: [Z YES ❑ NO If so, List- 115,� Variance: ❑ YES YNO If so, List: Intake to complete the following: ❑ YES [�NO Is use in LI, HI or PDIP zoning? Engineer's Report (CER) packet. ❑ YES °[KNO 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 EP"N0 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 ❑ NO Will you be putting up a new sign of any kind? If so, obtain proper Sign ermit. � Permit # % v�� fr s ©,YES ❑ NO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # o70D �o of �7d ALI Z% ❑ YES 2--NO Is this for sales of Fireworks? If so, obtain a copy of F/R permit. Permit # Proffers: ❑ YES [v]'NO If so, List: SP's: Vf YES ❑ NO If so, List: �/ 4� { r mac- 1qL3 — 5/1/06 Page 3 of Reviewer to'complete the follPwing: Square footage of Use: folly wing: [YES ❑ NOnn ,�, r Permitted as: I v [ W-W i b VW &T uP./ Under Section: 0,5i,; , 1 ( I j � 0 J ,� ' i (j) Supplementary regulations section: I GA Parking formula: A- -04 Required spaces: ❑ YESNO Items to be verified in the field: Inspector Name & Date: Notes 5/1/06 Page 4 of 4