HomeMy WebLinkAboutCLE200500100 Action Letter 2017-08-01a44-q�
Application for Zoning Clearance =
OFFICE USE, ONL�, _
CLE #
❑ Zoning Clearance = $35 Check # Date:
PLEASE REVIEW ALL 4 SHEETS Receipt # Staff:
PARCEL INFORMATION
Tax Map and Parcel: flop- Do- ob— I Z400 Existinb Zoning Opr'eIG
Parcel Owner:_ KIO Fdst 1-LC.-
Parcel Address:_ WC15. R10 emst 'Covf— City 0_VkAW-%AA&'j41e.- State V Zip
/�g -(include suite or tloorr
APPLICANT INFORMATION �y i
Who should we call/writ+: concerning this project? _ �Ibti 4L C'10.c.%%+ YVITM0i
— ----- -
Address :�315�� Se dS�n I��.+ay City GbnrioAlaes-41k# State V4 zip 7 i 1 1.
Office Phone: &34) OM_- 1190 Cell #434- T0b— (PSI (o Fax # -9$' -134Z E-mail OMWa
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PROJECT INFORMATION
-usiness Name/Type: Q.I 4.rr7i�V fta;(.JrwC
Previous Business on this site: >A — Gt+r0e4•VcM
Proposed use: ;G OA
Circle (if applicable): Firetiverks / 6hpistrnes4 e
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRIS'I MAS TREE SALES
*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 nCw Zonim
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 aiso ccrtifa that dli' iia10r111a!iou h .icicjcj
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 .S 14
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APPROVAL INFORMATION
( ) Approved as proposed
0) Approved with condition 'ackmw
Trst =4_04*
Building Official Date
Coning Official Date 0
Other Official
Date
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County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
3,2810I'a_e 2 ol'-i
Intake to complete the following:
Applicant to complete the following:
Q'�l / N
o you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
N
o 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.
to complete the
Y
If
Y
If
Y
If
Y/N
Is use in LI, III or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y /M
WillWere be food preparation?
If so, give applicant a Health Department corm.
Zoning review can not begin until we receive approval from
Health Dept. FAX DATE _
YlE)
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
b/ N
Is on public water and sewer?
RYIN
ill you be putting up a new sign of any kind'? If so, obtain
proper Sign pen -nit.
Permit #
VYIN
ill there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Yl
Is thr for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
3/28/05 Pa-e 3 of 4
R4 VJL-% L4r CO cumprere the rRPIICPW Fkg:
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YIN
tnnit�r�l :G�:lVl4S►Lq, tI✓e �.�i �C.✓ 1 �/?�5
u�{}lx min ty r�+ ullftian c�Iion:
Parking formula: _:L— -5 w 2z SjrF tjE�
Required spaces: 3� ��� `S { 11S c5` T
f l ,1 v► i�tS� �o �a S
t�rlls to be k�crife�.� in tlu t�rld: �►��
Inspector Name & Date:
Notes
3/28/05 . ,1-. - I oF4