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CLE200500218 Action Letter 2017-08-02
.pplication for Zoning Clearance OFFICE USE ONLY Q ❑ Zoning Clearance = $35 CLE # Check # Date: PLEASE REVIEW ALL 3 SHEETS Receipt # 4 Staff: ZT' v — aq-05 PARCEL INFORMATIMO �hnn //ll Tax Map and Parcel:1J ' tlV� `f �V Parcel Owner: Parcel Address: -(include suite or floor) -------------------------- -------- Existing Zoning f to City StateL2QZi�60 APPLICANT INFORMATION Who should we call/write concerning this project? Ja-- Address city State I/A Zip �� 3 Office Phone: { ] Cell # JC Fax # E-mail ; ��¢_ � d ------------------------------------------------------------------------------------------------------------------------------------------------ PROJECT INFORMATION Business Name/Type: A 7 ,! Previous Business on this site: Proposed use: S IAJ 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. 1 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 e;,o /, • Zj _t : E•: ------------------------------------------------------------------------------------------------------------------------------------------------ APPROVAL INFORMATION ( ) Approved as proposed ( ) Approved with conditions Building Official r— Date�� _ Zoning Official Date _ I ©/12/ oS Other Officf Date ----------------- - --m 4!E Emnx:Q57CIL--------------------------------------------------------------------- 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 V 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 Can not issue until we receive approval from Health Dept. N Is the parcel on private well and septic? If so, fax application to Health Department. FAX DATE 8 aZ5 Lck--� Can not issue until we receive approval from Health Dept. Y /[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 u, Y //OKD Will there be any new construction or renovations? If so, obtain the proper Permit. Permit #_ Y 1(9Is this for sales of Fireworks? VV If so, obtain a copy of FIR permit. Permit 4 Zoning Tech to complete the following: Viol ions: Y /0 If so, List: -- 2-0 1 l l AbAffD VarNce: Y /r N) If so, List Reviewer to complete the following: Pra s: Y /0 If so, List: SPISM Y // N J If so, List: Square footage of Use: gs5# Permitted as: Under Section: A Supplementary regulations section: Parking formula: acre spaces: J N Items to be verified in the field: