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HomeMy WebLinkAboutCLE200600293 Legacy Document 2015-02-10Application for$ Zoning Clearance mg Clearance = $35 PLEASE REVIEW ALL 3 SHEETS Tax map and parcel: ` Existing Zoning: p nn r Parcel Owner: i J 1 c k'. J' , CL.- LL C, Parcel Address: 1(0 F&kyn NA City State u A Zip r1aak �0 � (include suite or floor) nn ` Contact Person (Who should we call /write concerning this project ?): Rc {k hlfurn6 v\y\ Address I& s-0 A FAA rn ll u& , City t (& State uA Zip Day C) / Daytime Phone ( ±3tb 1;_-7y1Y0 Fax # ' 3_J) 577'x%`7 5-) G E -mail Business Name /Type: }S eoogKS LLC. l)(3A klpli 1e Hads cbenni-u SC�Jya'ee Previous Business on this site: IQ ✓i Proposed use: D FF 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 f my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by theme P /,-)-i r -o Signature of Business Owner or Agent Date 9c,(4 N ev✓r1a��\ 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 with the existing site plan. ] This site complies with the site plan as of this date. Building Official Date — �f 6 Zoning Official Date 2- 12-2,16 6 Other Official Date FOR OFFICE USE ONLY CLE # CX&O q Fee Amount $_'3S, O 0 Date Paid LZ -tL -00 By who? e'er S LUl Receipt # 631 S 3 Ck #C_ 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 piicant to complete the frollowing: 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) ❑ 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. `0JS5ri J4 : oning Tech to c Violations: ❑ YES ONO If so, List: Variance: ❑ YES VINO If so, List: the Intake to complete the following: ❑ YES E;_ Is use in LI, HI or PDIP zoning? Engineer's Report (CER) packet. ❑ YES Li� I / 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 ©�O 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? ❑ YES S-1�0 Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑ YES ENO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # ❑ YES NO 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 [0 NO If so, List: 5/1/06 Page 3 of Reviewer to complete the following: S:Iuare ootage of Use: 600 YES ❑ NO % j Permitted as: � Q - I ( ,�'� Under Section: J..ec ((I C-) Supplementary regulations section: J Parking formula: O Required spaces: °2 ❑ YES eNO Items to be verified in the field: Inspector Name & Date: Notes 5/1/06 Page 4 of 4