HomeMy WebLinkAboutCLE200500214 Action Letter 2017-08-02wy
Application for Zoning Clearance
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❑ Zoning Clearance = S35
PLEASE REVIEW ALL 3 SHEETS
OFFICE USG ONLY
CLE #
Check # Date:
Receipt # Staff: IYVI it
PARCEL INFORMATION ,p
Tax Map and Parcel: [5 6 o�Q, a) -Q7 041Jw Existing Zoning 1
Parcel Owner: ' c� 1 _{_ C —;;NJ,Q ,s ����
Parcel Address: ; `" "'s (I - Al i E CityC �"1�': �f ti c t �'sti� M� ate �Zip!:,`q C )
__(include suite or flo )_
APPLICANT INFORMATION
Who should we call/write co cer!gpg this project?
Ir-3 1
Address
Office Phone: LJ
I'SLA %
Cell #
trc� City 1 C.QC, - State Zip
SCC'l
Fax #
E-mail
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PROJECT INFORMATION 1
Business Name/Type:
c
Previous Business on this site:
Proposed use:
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.
I'
Signatures ' l t C�_ C • [ Printed C z 1 Uur1
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APPROVAL INFORMATION
( ) Approved as proposed ( } Approved with conditions
Building Official Date
Zoning Official
Other Official
Date
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
pplicant 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) Mote 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 1C_/ 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 % N 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.
COY N Is the parcel on public water and sewer?
rY �/ N Will you be putting up a new sign of any kind?
�� If so, obtain proper Sign permit. Permit #
Y I N Will there be any new construction or renovations?
If so, obtain the proper Permit. Permit #
Y / ti Is this for sales of Fireworks?
If so, obtain a copy of FIR permit.
Zoning Tech to complete the following:
Violations:
Y I N If so, List:
Variance:
Y I N If so, List
Reviewer to complete the following:
Square footage of Use:
Under Section:
Parking formula:
Y 1 N Items to be verified in the field:
Permlt #
Proffers:
Y I N`' If so, List:
SP's:
Y i bi If so, List:
Permitted as:
Supplementary regulations section:
Required spaces: