HomeMy WebLinkAboutCLE200500255 Action Letter 2017-08-03C
Ax .- Icatzon for Zoning Clearance 1, C'e- up16 :
[Zoning Clearance = S35
PLEASE REVIEW ALL 3 SHEETS
OFFICE USE 25i�
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CLE #
Check # 10 1 Date: Z p
Receipt # Staff-
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PARCEL INFORMATI N
Tax Map and Parcel: "I DQ-00_-4 _-n r �0 Existing Zoning
Parcel Owner: ki 17 A55 I a 1,I m '1-e_J1"GLY-f�m ck. ;h r
Parcel Address: 6 z o A -I bemaAe, S agye, CityLf! 1 1 ++Mate V Zip
--(include suite or floor- ---------------------------------------------- --- - ..._
APPLICANT INFORMATION p' Faw e- I a- 44 WP� /,O hyi A. G�� �Ir
Who should we call/write concerning this ro'ect2 _ ' L ! Q
Address: 4 Gandom 6ow-# CityRk(, �1�,51/�14G State V ZIP 2Z -iOffice Phon�5"103 MOO")
g � Fax # E-mail /��'j G� Y1 e��Unet
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PROJECT INFORMATION
BusinessName/Type: __ __ _ A ,rwOn(S 94tJ ra — &.�sV les5om s4uAio
Previous Business on this site: / of s U k'A Y 6E yo cl0 R
Proposed use: 14- lessons
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 knowledge. I have read the conditions of approval, and I understand them, and that will abide by them.
Signature Printed Pa'M ei` q-, 6'e-�L-w
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APPROVAL INFORMATION
( ) Approved as proposed proved with conditio 01
Building Official c �~ Date
Zoning Official Date 14'N
Other Official
Date
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County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax. (434) 972-4126
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✓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?
If so, give applicant a Certified Engineer's Report (CER) packet.
Can not issue until CER is approved by the County Engineer.
Y & 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 1 I�T 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?
I N 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 16) Is this for sales of Fireworks?
If so, obtain a copy of FIR permit. Permit #
Zoning Tech to complete the following:
viol ons:
Y /U If so, List:
U
ariance:
I N if so, List
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Y � N If so, List:
Y N If so, List:
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Reviewer to complete the following: `
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Square footage of Use: i�! d 6 Permitted as:
UnderSection: Supplementaryregulations section:
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Parking formula: Required spaces:
Y (ffl Items to be verified in the field: