HomeMy WebLinkAboutCLE200500107 Action Letter 2017-08-01Application for Zoning Clearanceo
OFFICE
❑ Zoning Clearance = $35 CLE # -
Check # Date:
PLEASE REVIEW ALL 3 SHEETS Receipt # Staff :
PARCEL INFORMATION j C
Tax Map and Parcel: 33 $ Existing Zoning_1
Parcel Owner: IT, vy, 010
Parcel Address:? •o. -bO 19
+ 3 City State A Zip -M-o—z
,______(inclu a i'trite yr iloor�_ -------------------------------------
APPLICANT INFORMATION
Who should we call/write concerning this
Address • z 5 City ACAL t ' State Zip ZziS
Office Phone: Cell # ��3 I. l l i q l • O 0 E-mail
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PROJECT INFORMATION
Business Name/Type:
Previous Business on this site:
Proposed use:
Circle (if applicable): Fireworks / Christmas Tree
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet3)
*'Iltis 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.
1 hereby certify that I own or have the owners percussion 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.
.1 f
Signature Printed �JON Q 6 eJ ul
APPROVAL INFORMATION
Approved as proposed
Building Official �4
Zoniag Official �.
Other Official
_X
Approved with co ttriandw Deria
Tod Deft
Date
Date (Z 7 f
Date
................................................................................................................................................
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126
3/3/2d05
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 I N Is the use in a LI, Hl or PDIP zoning?
I€ so, give applicant a Certified Engineer's Report (CER) packet.
Can not issue until CER is approved by the County Engineer.
Y / 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 ! N 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.
Y I N Is the parcel on public water and sewer?
Y I N Will you be putting up a new sign of any kind?
If so, obtain proper Sign permit. Permit #
Y/N
Will there be any new construction or renovations?
If so, obtain the proper Permit. Permit #
Y I N Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Zoning Tech to complete the following:
Violations:
Y / N If so, List:
Variance:
Y / N If so, List
Reviewer to complete the following:
Square footage of Use: ��d &C� _Cis
Under Section:
Parking formula:
Y /'terns to be verified in the field:
Permit #
Proffers:
Y I N If so, List:
/ N If so, List:
Permitted as:
Supplementary regulations section:
Required spaces: v,(D