HomeMy WebLinkAboutCLE200500225 Action Letter 2017-08-02Ali 1
ty
Application for Zoning Clearance
OFFICE USE f�NLY
CLE # [�
❑ Zoning Clearance = S35 Check # Date:
PLEASE REVIEW ALL 4 SHEETS Receipt # Staff:
PARCEL INFOR
Tax Map and Parcel:
Parcel Owner: H r
Parcel Address:
City
____-----_include suite or floor)-------
-------------------------------------
Existing Zoning
State
Zip
APPLICANT INFORMATION �� ���
Who should we call/write concerning this project? {`j, + r F -�
Address • 153'L 1h�aYKQ CityCtlGil&kre-,ViQV State k Zip .
Office Phone: d!�$ " 14MCell # 439V % Fax # 4434 E-mail PU,15 (3 AVn4Pe- U)4=— <CA(
--------------------------------------------------------------- 1921------------ 293- 9654-------------- -
PROJECT INFORMATION
Business Namerrype: ARKA(1EC�i3RE
Previous Business on this site:
Proposed use: aFfiaE
Circle (if applicable): Fireworks 1 Christmas Tree
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet 1)
*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 th wn have the o 's permission to use the space indicated on this application. I also certify that the information provided is
true and accurate the I I have read the conditions of approval, and I understanid them, and that I will abide by them.
Signature Printed P=t4
APPROVAL INFORMATION
( ) Approved as proposed
( ppproved with
Building Official Date ( s; a
Zoning Official Date
Ll
Other Official Date
------------------------------------------------------------------------------------------------------------------------------------------------
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5932 Fax: (434) 972-4126
3/28/05 Page 2 of 4
Intake to complete the following:
Applicant to complete the following:
Y/N
Do you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
Y/N
Do you have a Floor Plan (sketch or an architectural drawing) that
includes the following, and if so please provide it with the
application?
The total square footage of the use and/or;
The square footage of each room or area of use;
Use of each room or area
If using less than the entire structure, note the location within the
structure.
sorting 'Tech to
Viu na:
YIN
i�5o, �15r:
the
YIN
Is use in L-114MW PDIF zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
�Y/
Wilr6ere 6e food preparation?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from
Health Dept. FAX DATE
Isl
Is phrCel on private well and septic?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from
Health Dept. FAX DATE
�21 N
I s on public water and sewer?
Y
Wi be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
Y
Wi be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
IsI
Is thior sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Yar lace: sp,
Y Y N
Gfso,
3/28/05 Page 3 of 4
Reviewer to cnmplece the Following:
Squ
are footage of use: 1t
7
QIfined as:
Under rction:
5upplcmenlwy rtgulafians scoiow-
NrUnp-fcimlolw. �'�i 22
v
Rc'quimdspaccs: �q�se.•e+o
Y
16-mx he verilird in the field;
Inspector Nune & Date;
Notes
3P,SHI5i ge4of'4