HomeMy WebLinkAboutCLE200500197 Action Letter 2017-08-01Application for Zoning Clearance
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OFFICE USE ONLY w2:�
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Zoning Clearance a $35 CLE # G Q0
Check # Date: i /z -
PLEASE REVIEW ALL 3 SHEETS Receipt # Staff:
PARCEL INFORMATION s
Tax Map and Parcel: (DIM C)D 0 1 30 t)O Existing Zonin
Parcel Owner: �cSDCi[a S
Parcel Address: J J� �CJi, (�El City �6L lti k State Vrp�%� Z
-------- include suite or floor ----
APPLICANT INFORMATION
Who should we call/write concerning this project?
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Address • �(� City
Office Phone: 6LIA) �1 Cell 70) 110-0AFa
PROJECT INFORMATION
Business Name/Type:
Previous Business on this site:
Proposed use:
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6104-7WIlft State Zip - i0 !
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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 1 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 Printed0AC
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APPROVAL INFORMATION
( ) Approved as Proposed _ greed -with conditions
Building Official �~ Date —)
Zoning Official
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
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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?
If so, give applicant a Certified Engineer's Report (CER) packet.
Can not issue until CER is approved by the County Engineer.
Y /8Will there be food preparation?
If so, fax application to Health Department. FAX DATE
Can not issue until we receive approval from Health Dept.
Y / ®Is the parcel on private well and septic?
If so, fax application to Health Depamnent. FAX DATE
Can not issue until we receive approval from Health Dept.
N Is the parcel on public water and sewer?
Y Will you be putting up a new sign of any kind?
If so, obtain proper Sign permit. Permit #
Y /f N ) Will there be any new construction or renovations? r� / 1 7
L/ If so, obtain the proper Permit. Permit # d M 5.6 ` —R✓Y�`
Y Il/ 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, L'
Variance:
Y / N If so, List
Reviewer to co lete the following:
Permit #
Proffers:
Y / N If so, List:
SP's:
Y / N If so, List:
Square footage of Use: G o Permitted as:
Under Section: s vac -Vv'- Supplementary regulations section:
Parking formula:
Y Items to be verified in the field:
Required spaces: