HomeMy WebLinkAboutCLE200500254 Action Letter 2017-08-03t�
It
L
.0
07
pplicat! A -a
frig Clearance "
OFFICE [lS� ONLY
Zoning Clea�cg 5 CLE # �.
Check # Date:
PLEAS Receipt # Staff:
PARCEL INFORMATION
Tax Map and Parcel: D (or o _ 0 n -- LZ2 Existing Zoning
Parcel Owner- ,
Parcel Address: - ` State- Zip 7�Z/`
Sinclude 'suite or floor) -
APPLICANT INFORMATION
Who should we caIl/write concerning this project? LQ M C L- 1
Address4 City f' State
Office Phone: 1. W - U776 Cell # Fax # E-mail
------------------------------------------------------------------------------------------...-------------------•----------
PROJECT INFORMATION
Business Name/Type: Z-� T ✓L U fib
Previous Business on this site:
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 ownees 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. l have read the conditions of approval, and I understand them, and that I will abide by them.
Signature 1 ��,_ /� - — Printed W, r/t3 M fl S-S
APPROVAL INFORMATION e* ;A
( ) Approved as roposed �qApproved with conditions
e -
��
Building Official Date .
Zoning Official Date 104
Other Official Date
-----------
........................................ ..� .._._r-Q�7 :�?-� �_..•-----------_---...--- -- - - -
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126
Pace 2 of 3
VA
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 / N 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 /[ N J 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 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.
JI
J I (N) Will you be putting up anew sign of any kind?
If so, obtain proper Sign permit. Permit #
N Is the parcel on public water and sewer?
Y 1 NO Will there be any new construction or renovations?
If so, obtain the proper Permit. Permit #
Y / Is this for sales of Fireworks?
`J If so, obtain a copy of F/R permit. Permit #
Zoning Tech to complete the following:
Via s.
Y U If so, List:
Var' e:
Y I N If so, List
Pro
Y N If so, List:
71
l N If so, List:
Reviewer to complete the following: r t l
Square footage of Use: lar.04 5 .-tl+i Permitted as;
Under Section: �� L'2 Supplementary regulations section:
Parking formula:
Required spaces: C-OS— 1�2
Y 5 Items to be verified in the field: