HomeMy WebLinkAboutCLE200500235 Action Letter 2017-08-02Application for Zoning Clearance 5A
OFFICE USE ONLY
❑ Zoning Clearance = $35 CLE # -
Check # Date:
PLEASE REVIEW ALL 3 SHEETS Receipt # Staff:
QS ? -7 -of
PARCEL INFORMATION
Tax Map and Parcel:
Parcel
Parcel Address:
_----------- _(include suite
Existing Zoning_0) W,
APPLICANT INFORMATION n
Who should we call/write concerning this project? Il I'i A E
Address: 2 f City
Office Phone: ( j r 1
27 Cell # ZIA ; I -&V Fax # 4kJ-J7%-7127
State VA Zip
E-mail
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PROJECT INFORMATION fjj I
Business Name/Type: U Z lI et Z&Aezo1-,ax4
Previous Business on this site:
Proposed use: '' wi
Circle (if applicable): Fireworks / Christmas Tree
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet3)
'Mis 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 owners 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 1 understand them, and that I will abide by them.
Signature �/_�Printed mri 04,
----------~�------------ -------------------------------------------------------------------------------- -- -----_--------.-------
QPROVAL INFO ATION
( ) Approved as proposed ( } Approved with conditions
Building' Date
Other Official Date
—0 Co
Countyof Albemarle Department of �ni Develo meat
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126
3/3120(s5
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 .� Is the use in a LI, HI or PDIP zoning?
�� j� If so, give applicant a Certified Engineer's Report (CER) packet.
Cannot issue until CER is approved by the County Engineer.
`Y ,!/ N Will there be food preparation?';LV�
�J If so, fax application to Health Department. FAX DATElftM I
Can not issue until we receive approval from Health Dept.
Y INN 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.
' N Is the parcel on public water and sewer?
Y I/ N Will you be putting up a new sign of any kind? ,
If so, obtain proper Sign permit. Permit #
r' N Will there be any new construction or renovations?
If so, obtain the proper Permit. Permit #
Y / Is this for sales of Fireworks?
V If so, obtain a copy of FIR permit. Permit #
Zoning Tech to complete the following:
Viol onI
Y 1 � f so, List:
L MAIM
rtance:
Y I .N If so, List
JA- o�
Reviewer to complete the following:
Square footage of Use: 'vm'
Under Section: -z. —1 4''a• �'
Parking formula:,.L6r
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Items to be verified in the field:
%' N If so, List:
S
VI N If so, List:
S
Pemutted as:-E�
Supplerrxntary regulations section:
Required spaces:
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