HomeMy WebLinkAboutCLE200500102 Action Letter 2017-08-01Application for Zoning Clearance �aT
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OFFICE USE ONLY
Zoning Clearance = $35 CLE # RIAQ
c1F# Date:
PLEASE REVIEW ALL 3 SHEETS Receipt # Staff:
PARCEL INFORMATION ` 1T��
Tax Map and Parcel: ()Cp O D O O � 13 0 0 V Existing Zoning f�D-21�
Parcel Owner: 13Q
Parcel Address: 15 ? l E IC t d -RA City C. a,)-{ bffeSUJ1e�tate V l•T Zip A—_4?6F
Include suite or floor
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APPLICANT INFORMATION � � `� J � I � r 5 a + I
Who should wercali/write concerning this project? /�
Address: 0 R d City 0 TIC S:d �� �wSiate �1 Zip O�qd
Office Phone: (T *t "/ I a--797 d -Cell # Fax # � � � � E-mail � Zc
PROJECT INFORMATION
Business Name/Type;
)e'1 V OV I & Nu a
Previous Business on this site: Noke,,
Proposed use: l 1 Ill w �{ e N '� a,� eRu c5
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Circle (if applicable): Fireworks / 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 the best of my knowledge. I have read the conditions of approval, and I understand them, and that 1 will abide by them.
Signature Printed �d C, R'CkeV-56 f V
APPROVAL INFORMATION
( ) Approved as proposed >) Approved with conditions
Building Official Date
Zoning Official ItDate �-6
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) 9724126
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) A 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 / N Is the use in a LI, M 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 /@ 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 I N Is the parcel on private well and septic?
I1//4 If so, fax application to Health Department. FAX DATE
Can not issue until we receive approval from Health Dept.
Y I N Is the parcel on public water and sewer? IV
N
YIN
Will you be putting up a new sign of any kind?
If so, obtain proper Sign permit. Permit #
Will there be any new construction or renovations?
If so, obtain the proper Permit. Permit #
Y ! N� Is this for sales of Fireworks?
If so, obtain a copy of FIR permit. Permit #
Zoning Tech to complete the following:
Vi a ns:
Y t N If so, List:
V riance:
Y N If so, List --7 :�5 r
Reviewer to complete the following:
Y AN ] If so, List:
If so, List:
Square footage of Use: Wvl" f 4cz7L Permitted as:
Under Section: rlAnL.,Supplementary regulations section:
Parking formula:
Y !Sltems to be verified in the field:
Required spaces: 3