HomeMy WebLinkAboutCLE200500257 Action Letter 2017-08-03,.pplication for Zoning Clearance .
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OFFICE USE QNLY �, a
❑ Zoning Clearance = $35 CLE # pG�
Check # Date:
PLEASE REVIEW ALL 3 SHEETS Receipt # Staff.
Ga 1-310 -05
PARCEL INFORMATION 1
Tax Map and Parcel: 112 Existing Zoning_/? C
Parcel Owner: \J0LVj0JEe W&Aj&,�
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Parcel Address:�p -e j(}/S Tr U City i fW jQkUi! If- State VA. Zip -�Pq��
_(include suite or -floor)-- ------------------------------------------ -- -------------- - - --
APPLICANT INFORMATION ��� K n� IfL�iQ �l filer
Who should we carll�/wr(i�te�c�o�ncerning this p�roj�ect? 1�
Address : _ —L1,1 - , ®.ii, ..---- City State - - I-1 h._ _ Zip Q
Office Phone: (may) M 0816 Cell # L1;4 -.IL19 -19140Fax # E-mail
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PROJECT INFO]
Business Name/Type:
Previous Business on this site: c r t _ t (fit n
Proposed use: A(),nfllnej !SoA n-
Circle (if applicable): Fireworks 1 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 anew location, anew Zoning
CIearance will be required.
I hereby certify that I own or have the ownces 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 by them.
Signature 1, Printed CJJQ -I- S
APPROVAL INFORMATION
( ) Approved as proposed
Approved with conditions
Building Official Date tam b S
Zoning Official Date t 51 ? lb s
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Other Official Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126
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.
Cannot issue until CER is approved by the County Engineer.
Y /- N) 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 /%, N 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.
Y/ N Is the parcel on public water and sewer?
Y.) 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 N Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Zoning Tech to complete the following:
Permit #
ViM
s: offers:
Y If so,List: Y N If so, List:
N�' l
Y ]I N If so, List
/ ►) A 1 Ar?G--
Reviewer to-co*plste the following: fl,
Square footage..of Use: .
Under Section: S 2
Y� / N If so, List:
Permitted as: !f
Supplementary regulations section:
a
Parking formula: Required spaces:
Y 1 N Items to be verified in the field: