HomeMy WebLinkAboutCLE200500086 Action Letter 2017-08-0103/31/2005 10:35 FAX 434 972 4128 RLD CODE & ZONING [ifl02'
Application for Zoning Clearance -
a.
OFFICIG v v
ea9ng Clearance a S35 CLE #
Check # Date:
PLEASE REVIEW ALL 3 SHEETS Receipt # Staff: S
PARCEL INFORMATION � �� q���
Tax Map and Pared., C2 � �� �0 _ Ezfstine Zonis i1
Parcel Owner: —TGw11
Parcel Address: City state Zip
.... • ......................(include caste or kcnd._-...._.-.......---..........----------...---...........-----...---------------........---
APPLICANT INFORMATION I
Who should we caplwritt eoneerming this project? tl� N UC CO ,skr toTt C_o ry- T , G. &, ( A({pngs1)
Address: TO. BOX ?q D I City Csul p— State \ � ZIP
OlTice Phones JrC—J-0) 3 �2 - 00 Cell # 510 - $-0b Paz r D �c�� Q fLC`t'; e4 r { �t �i rs . ►� e�
PROJECT INFORMA
Busisms Namenj 7es
Previous Business on this sites
Proposed use: rbe r _ 6hoe
Circle (if applicable): Fireworks l Christmu Tree
SEE CONDI77ONS OF APPROVAL IF THE CLEARANCE IS FOR FRUWORK OR CHItISTMAS TREE SALES (Sheet3)
*This Clearance wfli only be valid on the parcel for which it is approved. If you ehanix, intensify or move the use to anew location, anew Zoning
__Clearmea will be required.
i hereby certify that I own at have the owner's permission to use the space indicated on this application. I also certify that the information provided is
true sad accurate to the beat of my knowledge. I have read the corWitions of approves, and I understand theta and that I will abide by theta
Signature Printed
APPROVAL INFORMATION
( } Approved as proposed ( ) Approved with conditions
Building Official �r Date
Zoning 0t'fieizi _ Date , 117l0s ..
Other Official Date
_... ----- ----•- - ---County of Albemarle -Department -of Community Develovsment ..... ......................
_., 03/31/2005 10:35 FAX 434 972 4120 BLit CODE & ZONING
la 003
Applicant MUST HAVE the following information to apply:
1) Tax Map and Parcel or Address with Unit number or float if appropriate.
2) A Float Plan - eid= a skcsch or no arehiteemml dr&wia;
a) if using less tlran the entire stNct m. now the I=dDa within ire sue w=G;
b) Note the total square footage of the use;
c) Note the square foomge of oath morn or arcs of use;
d) Now the use of each mono Or area of use.
Intake to complete the following:
Y ! N 1, Is the we is a LL M or PDIP zonal.
��J if so, givo applicant a Certified Engineces Report (CER) packek
Can not issue until CER is apMvod by the County Engineer.
Y Iq/, Will time be food preparation?
+� If so, fax application to Health Department FAX RATE
Can not issue until we receive approval tlrom Heald: Dept.
Y � J 1s the Parcel on private well and septic?
If so, fax application to Health Department. FAX DATE
Cars not issue until we receive approval from Health Dept.
N Is the parcel on public water and sewer?
N Will you be putting UP a new sign of any kind?
If sa, obtain proper Sign permit. Permit N
J N Will titre be any new construction or renovations?05 235j �
If so, obtain the proper Permit. Permit #�'{ n]
N is thin for sales of FisewOdm?
V so, obtain a copy of FIR permit. Permit #
Zoning Tech to complete the following:
Y I N if so, List:
Variance:
Y / N If so, List
Proffers;
Y / N If so, List.
Y I N If so, List:
Reviewer to complete the fallowing:
Square footage of Use: , ! i 2- O Permitted as:
Under Section: � � • 2 . �l 2 Z. 2 - 4) supplementary rtipulations section:
Parldng forawla: i s Required siraces: _ 132� —
Y items to be verified in the field: