HomeMy WebLinkAboutCLE200500144 Action Letter 2017-08-01Application for ZoningClearance � V%
&D
�W� ❑Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
PARCEL INFORMATION
Tax Map and Parcel:
Parcel Owner:
OFFICE USE
CLE #
Check #
Date:
Receipt #
staff.
Existing Zoning PAS
Parcel Address:
City �,n 11� State zip
____________________ --_Sin--ude suite or 17oorj_-
APPLICANT INFORMATION "` "ff"`` "" �/v
Who should we call/write concerning this project? _ �'1 t q PONA-C4 ' l rr, Ca tLL t i i OW01 ;Z 7 Lmc
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Address :' Y1 Q �el,yZ,� city. L'1!►11� State J, ZIP IMCI j
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Office Phone: C__) Cell # - Fax # E-mail
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PROJECT INFORMATI N
Business Name/Type: 9
Previous Business on this site:
Proposed use:
C.
Circle (if applicable): Fireworks / Christmas Tree
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CMUSTMAS 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 permission 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 Printed 11
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APPROVAL INFORMATION
( ) Approved as proposed
( � ved with
PP
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Building Official Date �3
Zoning Official Date t M
Other Official
Date
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County of Albemarle Department of Community Development-•------ -----------
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401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
3/312005 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 / Is the use in a LI, HI or PDIP zoning? packet.
so, give applicant a Certified Engineer's Report (CER) p
Can not issue until CER is approved by the County Engineer.
t N Will there be food preparation?
if so;�axpglicatio�i t4_ Helth Department. FAX DATE
A.
f"• + ==1.. tY Can not issue until we receive approval from Health Dept.
r
l
Y i 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 / N Is the parcel on public water and sewer?
I N Will you be putting up a new sign of any kind? ; /`_
If so, obtain proper Sign permit. Permit # (�-�6a/cz-.
Will there be any new construction or renovations? e—
lf so, obtain the proper Permit. Permit # r l/t
y as this for sales of Fireworks?
f so, obtain a copy of F/R permit. Permit #
Zoning Tech to complete the following:
Violations:
y i N If so, List:
Variance:
Y / N If so, List
.j!-lt 1!"T
Reviewer to complete the following:
Square footage of Use: o�
Under Section: 6-74- `2 d
Parking formula:
Y 1(F) Items to be verified in the field:
Proffers:
Y / N If so, List:
SP's:
Y 1 IV If so, List:
Permitted as:
Supplementary regulations section:
Required spaces:�� '��