HomeMy WebLinkAboutCLE200500266 Action Letter 2017-08-03Application for Zoning
❑ Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
Clearance
OFFICE USE O Y
CLE # 5—
Check # Date:
Receipt # Staff-
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PARCEL INFORMATIN� '�y-� Tax Map and Parcel: 0 ~W -M —0,3j 60 _ Existing Zoning Po
Parcel
Parcel Address: City State
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(include suite or floors------------------------------------------------------------------ ---
APPLICANT INFORMATION �
Who should we can/write concerning this project? _ Z 4_ 14 EA
Address • LCO Q64,M", %,,4 S:►• re 13�J1
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Office Phone: 9 Q- � f �a Cell #
City n uA I -__ State Q Zip Z tt
Fax #
PROJECT INFORMATION
Business Name/Type:
Previous Business an this site: 1 1'k (% L-
Proposed use: `�J 3+bC-KS
E-mail
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 my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed 7:4 �n
APPROVAL INFORMATION
Building Official Date loblos
Zoning Official Date
Other Official Date
--------------- - ------ .......... =--.. -cas C�------ - -- ---------------------------------------
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126
SOS)
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;
A4b) 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 1 61 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 10 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 IND 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.
I N Is the parcel on public water and sewer?
DOS_,j19gA -
Y I N Will you be putting up a new sign of any kind?
If so, obtain proper Sign permit. Permit #
YIN
Will there be any new construction or renovations?
If so, obtain the proper Permit. Permit #
Y IS Is this for sales of Fireworks?
If so, obtain a copy of FIR permit.
Zoning Tech to complete the following:
Violations:
Y I N If so, List:
Variance:
Y 1 N If so, List
Reviewer to complete the following:
Square footage of Use: 2.,q a
Under Section:
Parking formula:
Y I N Items to be verified in the field:
Permit #
Proffers:
Y 1 N If so, List:
SP's:
Y I N If so, List:
Permitted as:
Supplementary regulations section:
Required spaces: