HomeMy WebLinkAboutCLE200500122 Action Letter 2017-08-01AP lication for Zoning Clearance pa"
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OFFICE USE�Y6❑ Zoning Clearance a S35 CLE #o2oZ
Check # Date: 1517
PLEASE REVIEW ALL 3 SHEETS Receipt # S Staff: Arwy
PARCEL INFORMATION
Tax Map and P/Existing Zoning
Parcel Owner:
Parcel Address: City State Zip
include suite or floor
APPLICANT INFORMATION
Who should we call/write concerning his project?
Address: C� �� c.0 �i 2 /t�r Y � lS0 G� 1
e�tyC'� �, State
Office Phone: Z t13 Cell # -'Z+ ZY/ Fax # E-mail
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PROJECT INFORMATION
Business Name/Type:
Previous Business on this site: /
Proposed use: � � (�� � d �xSSI i� C� _
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 owner's permissio;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.
Signature ; L l Printed c.
AL INFORMATION
ed as proposed
A_
fa"pproved with
Building Official Date
Zoning Official T, Date L
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
Applicant MUST HAVE the following information to apply:
I) Tax Map and Parcel or Address with unit number or floor if appropriat
2) A Floor Plan - either a sketch or an architectural drawing
a) If using less than the entire structure, note the location within
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, HI 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 1' N e 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 j 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.
N Is the parcel on public water and sewer?
Y kP Will you be putting up a new sign of any kind? �'CD Kw'�``�
If so, obtain proper Sign permit. Permit # I
Y Will there be any new construction or renovations?
`i If so, obtain the proper Permit. Permit #
Y 1 N ` Is this for sales of Fireworks?
If so, obtain a copy of FIR permit.
Zoning Tech to complete the following:
Y I N' i IVso, List:
V
1 N 11f Ao, List
Reviewer to complete the following:
Square footage of Use:
Under Section
Parking formula:
Y 11"N ) Items to be verified in the field:
Permit #
N ) If so, List:
Is:
I,N f so, List:
Permitted as:
Supplementary regulations section:
Required spaces: