HomeMy WebLinkAboutCLE200500221 Action Letter 2017-08-02Application for Zoning Clearance y�
OFFICE USE,n%rq
❑ Zoning Clearance = 535 CLE # (�
Check # Date:
PLEASE REVIEW ALL 3 SHEETS Receipt # 55 XnQU _ Staff: _
PARCEL INFORMATION
Tax Map and Parcel: (21 &—00 —00 0 1 1F6 Existing Zoning PPM�
Parcel Owner:
Parcel Address: pECF� £�rFERSb1Q IZK City C"t .C)'7MVUEState VA zip2z 11
______(include suite or floor)_
APPLICANT INFORMATION 1
Who should we caL
ylltwrite concerning this project? Rhlax 4 . ,bew D
Address S'Z 170City CHARL TTMI(LlF—State Zip I
Office Phone: (4*975 -2-555 Cen #
Fax # 974-(O9OD E-mail
PROJECT INFORMATION
Business Name/Type:
Previous Business on this site: RT= w
Proposed use:
Circle (if applicable): Fireworks I 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 anew 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 c e to the of o dge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed WIF—�—> \ LL. C—H IA
APPROVAL INFORMATION
( ) Approved as proposed
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( ) Approved with conditions 4t
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Building Official Date 5 0"
Zoning Official Date tL13&5 ��
Other Official Date OS
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County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126
3/3/2005
z 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;
r� ,p) 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 /(rIs 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 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 1 1 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.
/ ITT Is the parcel on public water and sewer?
Y / N Will you be putting up a new sign of any kind? -7
If so, obtain proper Sign permit. Permit # / l
Y / N Will there be any new construction or renovations?
If so, obtain the proper Permit. Permit #� _
Y / N Is this for sales of Fireworks?
If so, obtain a copy of FIR permit. Permit # _
Zoning Tech to complete the following:
Vioons:
Y / : If so, List:
btu�IC-?�3� ZBIP
Va ' ce:
Y A N If so, List
Pro rs:
Y / If so, List:
SPf0.\
Y 110 If so, List:
Reviewer to complete the following:
Square footage of LTse:' i Permitted as:
Under Section: �'1� �'Z'1 Supplementary regulations section:
Parking formula: �s NQ Required spaces: �G�S
-�
Y 4Items to be erified in the field: