HomeMy WebLinkAboutCLE200500198 Action Letter 2017-08-01Application for Zoning Clearance O."nm.,
OFFICE USF� O )L
Zoning Clearance - $35 CLE # O?
rr Check # Date:
PLEASE REVIEW ALL 3 SHEETS Receipt # Staff:
PARCEL INFORMATI
Tax Map and Parcel: — Existing Zoning_-
Parcel Owner: S �-ea E.siak
qr7Parcel Address: V �'1 t iC�V� Tl�� �Ity � y % } 1 e— State V Q , Zip
-_Sinclude suite or floor) -
APPLICANT INFORMATION
Who should we call/write concerning this project? D3015 VU Cf1CC_—
Address : City RkSVOSO f �� State Yq. ZipO?C'R&O
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Office Phone: �)q�S� 33 % Cell # �:LQ0 3 Fax # N p— E-mail �Ni�
PROJECT INFORMATION ],
Business Name/Type:
Scow }s Trc o
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Previous Business on this site: -SAS g CL-Lt i -S ,
Proposed use: n6 r asi' --PL-tnc+ ira i5,e c or- Ocy Sc_o c-j ,S
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.
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Signature�L Printed---- Q) I OS
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APPROVAL INFORMATION
( ) Approved as prop ed �►pproved with conditions
1
Building Official Date
Zoning Official Date �c
Other Official
Date
------------------------•---------------------------------••----...-----------•-•-----------------------------------------------•
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9W4126
31312005 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 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� 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 ON 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.
)0/ N Is the parcel on public water and sewer?
Y /LJ"" ill you be putting up a new sign of any kind?
If so, obtain proper Sign permit. Permit #
Yam" ill there be any new construction or renovations?
If so, obtain the proper Permit. Permit #
Y s this for sales of Fireworks?
If so, obtain a copy of FIR permit. Permit #
Zoning Tech to complete the following;
Viols:
Y 1/N/ If so, List:
Varta
Y 10 / If so, List
Reviewer to complete the following:
Proffers:
Y / N If so, List:
SP's:
Y / N If so, List:
Square footage of Use: Permitted as:
Under Section: Supplementary regulations section:
Parking formula: - — - --'L - Required spaces:
Y / Items to be verified in the field: