HomeMy WebLinkAboutCLE200600295 Legacy Document 2015-02-10Tax map and parcel:
Application for
Zoning Clearance
oning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
Existing Zoning:
��RGIN�P
Parcel Owner: EAf DL&S.S A"flwv'J
/
Parcel Address: G7,0 CA M k t -����, �� g City C t ✓t t-L - State '�/ 4 Zip'zzlb I
(include suite or floor)
Contact Person (Who should we call /write concerning this project ?):
Address 'D 06)c 2SN g— City
,:� ✓l t Le-
State ✓A Zip 2z-go Z
Daytime Phone (� rFax # � � 3 (o � � (_2 ��J4 S b l-JTl bnS ° S 3r
Business . Cam
Name /Type: ICJ � q 5, O L J 71 � S L-(-c
Previous Business on this site: /J�A (tE`J f3 L1) S 7)
Proposed use: 6b -K r 'tttit_ C-r+.J Su LT't 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 of my knowledge. I have read the conditions of approval, and I understand them, and that I will
abide by the
21 1.z. -mac— (�
Signature of Business Owner or Agent Date ,
Print Name vaplw' Devito and/or
j riCarMt Test Data Nwded
APPROVAL INFORMATION
[7J Approved as proposed
i
[O/Backflow device and/or current test data needed for this site.
[ ] No physical site inspection has been done for this clearance.
[V] This site complies with the sit 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 �,r a- o
Zoning Official Date `% bl
Other Official u I Date
FOR OFFICE USE ONLY
Fee Amount $ 5 �' Date Paid
CLE #
By who?
Receipt # i.�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
Applicant to complete the following:
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)
X 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.
Zoning Tech to complete the
Vio ations: VOA r11-14 0 a
YES ❑ NO
If so, List:
I 0 dO — A
d "Q — /�2 614-P -J
Variance:
❑ YES NO
If so, List:
Intake to complete the following:
E YES ❑ NO
Is use in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
❑ YES PINO
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 1d NO
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 [j NO
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
0 YES ❑ NO
Will there be any new construction or renovations?
If so, obtai the roper Permit.
Permit #N65 -- S 14
�� aI r
1:1 YES ro/No 60 �
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
❑ YES [2'NO
If so, List:
SP's:
❑ YES [j2/NO
If so, List:
5/1/06 Page 3 of
Reviewer to complete the follovlygg
Square foitage of Use:
VitYES El NO
ted as:
UV
Under Section: a - a - ( ( �J
Supplementary regulations section: I pt
Parking formula: 600 1 4o,
Required spaces:
❑ YES ['NO
Items to be verified in the field:
Inspector Name & Date:
Notes
5/1/06 Page 4 of 4