HomeMy WebLinkAboutCLE200500084 Action Letter 2017-08-01Application for. Zoning Clearance
OFFICE U E �Y�
❑ Zoning Clearance = S35 CLE # pit J e-
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Check # Date: 'a
PLEASE REVIEW ALL 3 SHEETS Receipt # Staff:
PARCEL INFORMATION ^
Tax Map and Parcel: —002 00 ` - (D0 Existing Zoning
Parcel Address: N A 6 City State Oa, Zips /
---------------------------- suite or floor ---------------------- -----------
APPLICANT INFORMATION
Who should we call/write concerning this project?
Address : '3-1�5 Sm;n aft" c �� s4, t7-3 City _ awl �����{� State Zip
Office Phone: lq?d) Z,d`lb -'951b _Cell #L[3' %E,?d1D Fax # E-mail
PROJECT INFORMATION
Business Name/Type:
Previous Business on i
Proposed use: ""t 1�int1ll
Circle (if applicable): Fireworks 1 Christmas Tree
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet3)
*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 owners 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.
Signature Printed g, c4g,, 2 40
77
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APPROVAL INFORMATION
( ) Approved as proposed ( } Approved with conditions
Building Official Date ( a
Zoning Official Date
Other Official Date
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County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 2%-5832 Fax: (434) 972-4126
3/3/2005 Page 2 of 3
Applicant MUST HAVE the following information to apply:
1) Tax Map and Parcel or Address with unit number or floor if appropriate.
2) Floor Plan - either a sketch or an architectural drawing
a) If using less than the entire structure, note the location within the structure;
b) Note the total square footage of the use;
c) Note the square footage of each room or area of use;
d) Note the use of each room or area of use.
Intake to complete the following:
Y 1� Is the use in a LI, HI or PDIP zoning?
If so, give applicant a Certified Engineer's Report (CER) packet.
Can not issue until CER is approved by the County Engineer.
Y 1 N� Will there be food preparation?
If so, fax application to Health Department. FAX DATE
Can not issue until we receive approval from Health Dept.
Y 1 N9 Is the parcel on private well and septic?
If so, fax application to Health Department. FAX DATE
Can not issue until we receive approval from Health Dept.
' / N Is the parcel on public water and sewer?
Y i l� will you be putting up a new sign of any kind?
If so, obtain proper Sign permit. Permit #
Y 1 (9. Will there be any new construction or renovations?
If so, obtain the proper Permit. Permit #_
Y /�T Is this for sales of Fireworks?
If so, obtain a copy of FIR permit.
Zoning Tech to complete the following:
Y 4 N) If so, List:
Y /I N j If so, List
Reviewer to
Square
Permit #
Pr s:
Y / If so, List:
Y d N) If so, List:
Permitted as: —
Under Section: t Supplementary regulations section:
Parking formula: Required spaces: to
i / N Items to be verified in the field: