HomeMy WebLinkAboutCLE200500112 Action Letter 2017-08-0104/25/2005 12:31 FAX 434 972 4126 BLD CODE & ZONING Q001
Application for Zoning Clearance
OFFICE U O/��
0 Zoning Clearance - 335
Check # pate;
PLEASE REVIEW ALL SHEETS Receipt # Staff:
PARCEL INFORMATION
Tex Map and Parcel: _QED — D O - 00 [}� „ Existing Zanin Co .+1✓c; a. % D`c�
Parcel Owner; �LvocE GAG �fa C 9'c d, Lv-d /3, llewif�' i S G-Lc S
ParcelAddress:,�,�5l `r7v;/ ACCL,� City zap off?'ejo 1
...........................(iricludg sine or noor�--•--.-- - ----------......................................................................
APPLICANT INFORMATION
Who should we call/write concerning this project. S /e✓
Address:/ 3a 131ur /�� arm city 4:571i,,rlo*sv.,Y& State _ �% _Zip 9o3
4ffree Phone: `fL3J, 973 - 55-71 Cell # 1T53-(-,73s— Fax # 973'SJS O ii jCs / - i �a�% t ��+/�, AE- -
]PROJECT INFORMATIOIJ
Business Namenype: X ! ro a Dwrae✓' /-"4 ,:k X rw
Previous lqusineas on this site: � ` f "� a i✓x�: %�
Pryjposed tine: La.AJ*-10V-S— 0166`�' 6r Zvi/ 2c��dd� ,1 f'�S _ L.LL
A.
e-a
Circle (if applicable); Fireworks / Christnus Tree
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE 1S FOR FMEWORK OR CMSTMAS TREE SALES (Sheet3)
'This Clearsaw will only be valid on the pared for which it Is approved, if YOU ehaag%�, intensify or move the Use to a new Iocarlon• a new Zoning
Ckwattee will be required.
I hereby certify that I own or have
true and accurate "c best of my
Sigm,=
owner's permission to use the span indicated on this application. I also certify that the infarmation providcd is
rwledge. I have read the conditions of apprvvnl, and I understand them, and that I will abide by them.
Foe
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TAI�;
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roved1 . ,.,.. 11111111Pitlit
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1!'�7 �►wilr.R�rf1''a: alw..; rla. �i r
Building Official
Zoning Official
Date -," t 11�
Date
P
Other Official _ _ _ Date
..------•........................_...........----------...._...................._-•-----------------------------RE-cr:...------
County of Albemarle Department of Community Development t
401 McIntire Road Charlottesville, VA 22902 Voice; (434) 29&5832 Fax; (434) 971-4126
APR 27 6�",35
5 -w
Applicant MUST HAVE the following infornimon to apply:
I) Tax Map and Parcel or Addmas with snit number or floe: if appaoprktef.
2) A Fktar Plan - ddxr a Wmkh as a aaimctmal drawing
a) if O"All lass Clean Oee eaf M strfWRSV, Dolt the location within the structures
b) Note the tool square &forage ofew am
c) Nate the aqW* footagt of each toots or was of use;
d) Nate the use of each raostf Gram of use.
Intake to eongAei a the f9t4ov EW
Y 10 Is tic use 1. a"Hi oar PDIP z~.
lTim, St" aPPbMt a Codified Englones Report (CM paaltet
COU not ist W >mtri CER is approved by the Cmwy Enginow.
Y ION Will there be faad prepmadW
1fS: fax q0mfift M Heaith Depfq bma FAX DATE
Can pM issue Mtd we raceive ageprvval fiom H95M Dept.
Y / N Is the parcel on private well and sepde?
li s%% arP to Heahh D FAX DATE �� J ,p
�i G
Csa not issue Md, we MI* approval fiam Realth Dept - 7
Y / N 1s the parcel an public avatar avid sewer?
Y /8
WiD you be WaIM up a new alga of aay lclad?
Hm4 obtain prapar Papot P"WR N
Y / N
Will cbm benr ww Conttrucdon erscoovedona?
a--
If so, obtain the proper Pak Penult #
Y /8
is Chas ivr sales ofFiscworb?
U v,,--/ ;'ovL y
If ^ obab a copy ofF/R pamit Pan* #
Zoning Tech to complete the Rimming..
Y ! N
List:
Proffer.
Y / N If so, Lusk
ZYMP i r
ii
V
Y / N
so, list
,s�
Y / N Use, List:
to
Squm ftageafUsa
Under sectiaet:
Fandiced as:
�Pp1]► mgnlatiomD seatian:
tea= �! �fRequind spaces_
YIN llama tube vedf nd in &a Gab:
r