HomeMy WebLinkAboutCLE200500263 Action Letter 2017-08-03Application for Zoning Clearance
❑ Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
PARCEL INFORMATION
OFFICE USE
CLE #
Check i �
Receipt #
16116/ ar ca
Tax Map and Parcel: Existing Zoning 7 1� mc�
l
Parcel Owner:_ (Y\ _A1� _,ki (] o
Parcel Address:_ I� �'S S�Vje Ste% QlA{ t11, L State Zip oac. � {
(include suite or floor) ------------------------------------------------------- ------------------
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APPLICANT INFORMATION
Who should we call/write concerning this project? S0S2r\- CYI 11`Ctlr.
Address : \5 :5 S he �rdZo- 9,&A Sk-CS City { �� State
Office Phone: iyk t (p - i.� LICell # Fax # A-t (a J!jj1JG{ E-mail Q`CLk S !0
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PRIMARY CONTACT r
Business Name/Type: V C i n ►
Previous Business on this site:
Proposed use:
Circle (if applicable): Fireworks / Christmas Tree
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CMUSTMAS TREE SALES (Sheet 1)
*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 my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature _ Printed _bu4Sc:`.(t MN1Wf\
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APPROVAL INFORMATION
[ ] Approved as proposed K
Approved with conditions
[ o physical site inspection has been done for this clearance. T it is not a determination of compliance with the existing
,.-Kite plan.
[ ] This site complies with the site plan as of this date. owW
Building Official Date l O
Zoning Official Dateyr��
Other Official Date
--------------------- ----'- ° - ---�Q� -��Q - - -- -------------------------------------------------------------------------
County of Al�emarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fag: (434) 972-4126
Intake to complete the following:
9/28105 Page 2 of 4
Applicant to complete the following:
t / N
you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
Y/N
Do you have a Floor Plan (sketch or an architectural drawing) that
includes the following, and if so please provide it with the
application?
The total square footage of the use and/or; a 40
The square footage of each room or area of use;
Use of each room or area
If using less than the entire structure, note the location within the
structure.
Zan iag Tech to complete the Folly win
�ola�ivr�s:
IN
so, List:
Ya ris a ce.
Yl
If so, ist:
Y / I.D.
Is use in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Yl
Will Ywre be food preparation?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from
Health Dept. FAX DATE
Isl
Is paVd on private well and septic?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from
Health Dept. FAX DATE
N
n public water and sewer?
Y I T
Will �q be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
Y /
Wil el�Cii re be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Is/
Is tha sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
so, List:
22jpf—U01 —61f
Rrviewer to complete the following -
'Square fnomgc of LTse: -Z GOs
9/29105 Pajzc 3 of
Xit[ed iis-
UnderSecdow2sA 2 . L .2 . l C66
apple ncmtary regUlations Section_
Parking formula: ZgaO @, %0'/ s 200
Required spaces:
Y /,62
]terns to be verified in the field -
Inspector Marne & Mtte:
Notes
1I28M Page 4 of 4-