HomeMy WebLinkAboutCLE200500242 Action Letter 2017-08-02Application for Zoning Clearance v- =
OFFICE USE ONLY-,
El Zoning Clearance - $35 CLE #
Check # Date:
PLEASE REVIEW ALL 3 SHEETS Receipt # Staff: _Sm
PARCEL INFORMATION Tax Map and Parcel: Q t)360 d o Op Ozj D Existing Zoning_ f \ //�
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Parcel Owner: Fo}c��e.(� �Ir?Gl.�/ �[7G.
Parcel Address.
K Cit3' .1s.
--------------- rnclude suite or floor
----------- ----------------------)------------------------------
APPLICANT INFORMATION
Who should we calltwrite concerning this project?
0
Address : ale 7 City rle'66-14; e- State 6 Zip p Cr
1�Ftatey 7ip OS
Office Phone: f �� 1 273 • S-0 Cell # Fax i��3�f 2104I67 E-mail
PROJECT INFORMATION
Business Name/Type:
Previous Business on this site:
Proposed use:
F. cc
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 Tn them
Signature
Printed % l f� �-R rG� C1GceI�kc .
APPROVAL INFORMATION
{ ) Approved as proposed 45Rpproved with conditions
Building Official IzZs,Date
Zoning Official —4ikDate &tj)qAM
Other Official
Date
............. ----------------------------•--------•-----•----- _______ _______ ____ _
County of Albemarle Department of Community Development - -
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 971-4126
3/3i200-).
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? packet.
If so, give applicant a Certified Engineer's Report (CER}
Can not issue until CER is approved by the County Engineer.
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 4!g� 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.
1 N Is the parcel on public water and sewer?
y Q) Will you be putting up a new sign of any kind?
If so, obtain proper Sign permit. Permit #
y Will there be any new construction or renovations?
If so, obtain the proper Permit. Permit #
y Gf N Is this for sales of Fireworks?
l� If so, obtain a copy of F/R permit. Permit #
Zoning Tech to complete the following:
Viol ns:
Y 1�T If so, List:
riance:
l Y N If so, List
,b S
6Q'7
Reviewer to complete the following:
Square footage of Use:
Under Section:
Prothrs.
Y /0 If so, List:
J N If so, List:
�5
Permitted as: - ""�-
Supplementary regulations section:
Parking formula: Required spaces:
y /qg Items to be verified in the field: