HomeMy WebLinkAboutCLE200500130 Action Letter 2017-08-01Application for. Zoning Clearance
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oning Clearance = S35 CLE # (�
Check # Date:
PLEASE REVIEW ALL 3 SHEETS Receipt # Staff: 1 DO —
PARCEL INFORMATION
Tax Map and Parcel: 5 00 00L 6 D Existing Zoning F
Parcel Owner: 9' fk 11'*-Y1 rnrlr an d A
Parcel Address:
city State
--------------------------- include suite or floor)_
APPLICANT INFORMATION
Who should we call/write concerning this project?
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Address
State
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Office Phone: I Cell # I AO '�+ � Fax E-mail jr(j I
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PROJECT INFORMA'
Business Name/Type:
Previous Business on this sil
Proposed use:
Zip
Zip;ZR, I I
'----- 6i- 6?-4X
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 pawl 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 ve the owner's permission to use the space indicated on this application. I also certify that the information provided is
true and accurate the y knowledge. ave read the conditions of approval, and I understand them, and that I will abide by them.
Signature�� r Printed`%ray
APPROVAL INFORMATION
( ) Approved as proposed
Building Official
IF
Zoning Official
Other Official
* Approved with conditions 4G56(
Date �j.Z
Date
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:
Tax Map and Parcel or Address with unit number or floor if appropriate.
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 IN 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.
r ii N Will there be food preparation? a
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If so, fax application to Health Department. FAX DATE
Can not issue until we receive approval from Health Dept.
Y I I r 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.
I N Is the parcel on public water and sewer?
Will you be putting up a new sign of any kind?
If so, obtain proper Sign permit. Permit #,
Y � / Will there be any new construction or renovations?
If so, obtain the proper Permit. Permit #
Y CN) Is this for sales of Fireworks?
If so, obtain a copy of FIR permit.
Zoning Tech to complete the following:
r>
List:
Y N1 Vf so, List
Reviewer to complete the following:
Permit #
Y � N l) If so, List:
Square footage of Use: &' Perrnitted as:
Under Section: z Al A 7 1-- d Supplementary regulations section:
Parking formula: c5u 06`y3 Required spaces: CO
Y IQN Items to be verified in the field: