HomeMy WebLinkAboutCLE200500251 Action Letter 2017-08-03Application for Zoning Clearance
OFFICE U E ONLY
❑ Zoning Clearance = S35 CLE # ✓C
heck # Date: 61
in PLEASE REVIEW ALL 3 SHEETS Receipt # C Staff:
CEL INFORMATION
1a ap and Parcel: a)(�� �D � � ��t? l r� 1� � Existing Zoning
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Parcel Owner:
Parcel Address: , r trn 1 It t`� city Irc),�y"Z�P�If 1I�State U zip
include suite or floor
APPLICANT INFORMATION
Who should we call/write concerning this project?
YLL 2 C. �.vC
Address:
1 S e W'i k)j- 'fC j t�'3 rj L_
City 0�' I +�4NIkLk State
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Zip 2-Lo
Office Phone: � � Z k� Cell #
Fax # E-mail
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PROJECT INFORMATION
Business Name/Type:
Previous Business on this site: `�c�Ike—
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Proposed use: r/�
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 ha the wnees percussion to use the space indicated on this application. I also certify that the information provided is
true and accurat the best o y7__v
iedge. I have read the conditions of approval, and I understand them, and that I will;abide by them.
Signature Printed 901Wif d_
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APPROVAL INFORMATION � � //
( ) Approved as proposed J pproved with conditions
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]BuildingOfficial
Date
z
Zoning Official e�f� Date
Other Official Date
-------------- ..._ ?9 -f .S�-- �'-[Q_ !:` .. .. ..............................
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126
3/3/2005 Page 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;
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:
n � P'
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Y 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.
Y / h=� Will there be food preparation?
6/ If so, fax application to Health Department. FAX DATE
Can not issue until we receive approval from Health Dept.
Y I 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.
YJ/ N Is the parcel on public water and sewer?
Y�
Y I(jT
Will you be putting up a new sign of any kind?
If so, obtain proper Sign permit. Permit #
Will there be any new construction or renovations?
If so, obtain the proper Permit. Permit #.
Y (NJIs this for sales of Fireworks?
If so, obtain a copy of FIR permit.
Zoning Tech to complete the following:
Violations:
Y I N If so, List:
Variance:
Y 1 N If so, List
Reviewer to complete the following:
Permit #
Proffers:
Y 1 N If so, List:
SP's:
Y / N If so, List:
Square footage of Use: Permitted as:
Under Section:
Supplementary regulations section:
Parking formula: Required spaces:
Y / N Items to be verified in the field: