HomeMy WebLinkAboutCLE200500201 Action Letter 2017-08-02Ap, ration for Zoning Clearance` r
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OFFICE US ONLY
❑ Zoning Clearance = $35 CLE # no— NO
Check # Date -
PLEASE REVIEW ALL 3 SHEETS Receipt # Staff:
PARCEL INFORMATION
Tax Map and Parcel: % —� C gab[ I'*V Existing Zoning
Parcel Owner:
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Parcel Address: City zip
--(include suite or floor)_---------------------------------------------------------------------
APPLICANT INFORMATION
Who should we call/write concerning this project? /
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Address : . ate Zip Z,Z�6�
Offlce Phone: Cell #
PROJECT INFORMATION /�
Business Name/Type: / __L _ � � IL %
Previous Business on this site: 2 : %Z
Proposed use: 6,5&/1 -,/- ee- X44 a-2oZ9 f
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 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 � �S+ �� -0 `ctc d
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APPROVAL INFORMATION �„
Building Official' Date FitA ca S
Zoning Official Date 05
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) 972-4126
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 I 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.
N Will there be food preparation? If so, fax application to Health Department. FAX DATE -12,2
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Can not issue until we receive approval from Health Dept.
Y I i�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.
N Is the parcel on public water and sewer?
Y I0 Will you be putting up a new sign of any kind?
If so, obtain proper Sign permit. Permit #
Y 1 �Will there be any new construction or renoKations?
If so, obtain the proper Permit. Permit #
Y I 'ls this for sales of Fireworks?
If so, obtain a copy of FIR permit.
Zoning Tech to complete the following:
Violations:
Y If, so, List:
Va nce:
Y If so, List
Reviewer to complete the
Square f tage of Use
Under Section: °S
Permit #
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Proffers:
Y /IP If so, List:
SP's:
Y / N If so, List:
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Permitted as • E t" S N
Supplementary regulations section:
Parking formula:1 AQC- 4ei( I0b05+— Required spaces
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Y 11 N Items to be verified in the field: _