HomeMy WebLinkAboutCLE200500209 Action Letter 2017-08-02A.Pplic:ation for Zoning Clearance om)""
OFFICE USE ONLY l �- p��y� q�
❑ Zoning Clearance = $35 CLE # f►_G OIL�IJ.J-"0a
Check # Date: . -
PLEASE REVIEW ALL 3 SHEETS Receipt # Staff; --M
PARCEL INFORMATION
Tax Map and Parcel:
Existing Zoning POW
Parcel Owner.• '
4 c
Parcel Address• I Ci 1,10 State Zi
include suite or floor
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APPLICANT INFORMATION
Who should we call/write concerning this project?
Address : ,o City Is State Zip
Office Phone: LJ Cell # %120ax#
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PROJECT INFOI
Business Name/Type:
Previous Business ou this site: NOW
Proposed use:
E-mail
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 theca, and that I will abide by them.
Signature Printed _ l) ��� 0 o
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APPROVAL INFORMATION
00 Approved as proposedGA pl.f
) Approved with conditions
Building Official Date �� a to -
Zoning Official Date 5 0 b
'Ither Official Date
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County of Albemar D partment of Community Development
401 McIntire Road Charlottesville, VA 229Q2 Voice: (434) 296-5532 Fax: (434) 9724126
Applicant MUST HAVE the following information to apply:
Tax Map and Parcel or Address with unit number or floor if appropriate.
2 A Floor Plan - either a sketch or an architectural drawing GWOX
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 G Is the use in a LI, HI or PDIP zoning?
If so, give applicant a Certified Engineees Report (CER) packet.
Can not issue until CER is approved by the County Engineer.
Y)/ N 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 ig Is the parcel on private well and septic?
If so, fax application to Health Department. FAX DATE
%LB
Can not issue until we receive approval from Health Dept.
/ N Is the parcel on public water and sewer?
/N
Will you be putting up a new sign of any kind?
If so, obtain proper Sign permit. Permit #,
N Will there be any new construction or renovations?'
! -
If so, obtain the proper Permit. Permit #
Y ' V Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Zoning Tech to complete the following:
Viol 'ons•
Y / �` f so, List:
Vari ce:
Y / If so, List
Permit #
N If so, List:
SP's:
Y / N If so, List:
Reviewer to complete the folhowing:
Square footage of Use: _ : ': ' Permitted as:
Under Section: Supplementary regulations section:
Parking formula: Required spaces: i 3
1 N Items to be verified in the field: _�
Revlewer to Complete the fallawing:
Square f'..1012se 0 Use
G1Y N
I� Permitted as:
1 Under Section: �✓1 z l� I�*d���p�
Supplementary regulations section:
Psrking Wrnola
Required spaces: 04 00-I , r T �f�ib✓
E U - 1
YIN
It .to be verified in the field:
Inspector Name & Date:
Notes
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