HomeMy WebLinkAboutCLE200500260 Action Letter 2017-08-03Application for Zoning Clearance a
OFFICE USE 0 Y
[✓]Zoning Clearance - $35 CLE #
Check # Date:
PLEASE REVIEW ALL 3 SHEETS Receipt # staff.. '
PARCEL INFORMATION aa,,rr����
Tax Map and Parcel: —00DC0 Existing Zoning_
Parcel Owner:
Parcel Address: I City State Zip
include suite or floor ------------------------------------------------------
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APPLICANT INFORMATION �� 1 �; ���' 110 �1cXd
Who should we calltwrite concerning this
Address
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Office Phone: (_� Cell # ax #
PROJECT INFORMATION
Business Namerlype:
Previous Business on
Proposed use:
E-mail
Circle (if applicable): Fireworks I 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.
1 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 tof my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed. I G, ayil uE
APPROVAL INFORMATION
( ) Approved as proposed
pproved with conditions
Building Official Date �ATLb V
Zoning Official Date 10146 5:
Other Official Date
............. -............. - - --- ...... r-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 2 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;
D 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 1 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 /i Is the parcel on private well and septic?
If so, fax application to Health Department. FAX DATE
E Can not issue until we receive approval from Health Dept.
�1 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 l N� Will there be any new construction or renovations?
If so, obtain the proper Permit. Permit #
Y / I Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Zoning Tech to complete the following:
Viol ns:
Y /b If so, List:
Permit #
vl N If so, List
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Reviewer to complete the following: j
Y I N i If so, List:
Y) / N If so, List:
Square footage of Use: = Permitted as:
Under Section: 2q10r Supplementary regulations section:
Parking formula: T^ 2co Required spaces:
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Y 4/jj7�Items to be verified in the field: