HomeMy WebLinkAboutCLE200500271 Action Letter 2017-08-03I ir
Application for Zoning Clearan
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OFFICE USE ONLY
Zoning Clearance = $35 CLE # Ci Z.
PLEA E REVIEW ALL 3 SHEETS Check # Date: to- ,
Receipt # Staff: IM, D'5
PARCEL INFORMATION Ct> rola4[K_
Tax Map and Parcel 3 - 00 -V0 - Existing Zoning
Parcel
Parcel Address: V/ City Cy; I le- State V � Zip 221/ 1
include suite or floor
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APPLICANT INFORMATION
Who should we call/write concerning this project? 1Wt" - 154 /Y' d LA C
Address • ! I City utate f
�_�—..M,� _ � Zip �1J�
Office Phone: rJ Cell #&/ax # E-mail
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PRIMA,k CONTACT
BusinessName/Type• SC e-fsE /`1A/t1-5C_yA4ic - ^^
Previous Business on this site: _ AF�40_ :k 10A01A(9Ce -- '�•
Proposed use:
Circle (if applicable): Fireworks / Christmas Tree
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR C_HRISTMAS TREE SALES (Sheet I)
*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 E
- --------INFORMATION - --- -------------------------------------------------------------------------------------------
APPROVAL
[ ] Approved as proposed �pprovedwith conditions
] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing
site plan.
[ ] This site complies with the site plan as of this date.
Current Test Data N
a ,x
Building Official Date 1� j
Zoning Official — Date l O S
Other Official Date
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unty of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
Applicant to complete the following:
Y A N
Do you have one of the following?
Tax Map and Parcel Number and or,
Address of use (include unit or floor if appropriate;
DI 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;
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.
Foning Tech to complete the
Vio ns:
YIN
If so, st:
ariance:
IN
F so List:
on
9/28/05 Page 2 of 4
Intake to complete the following:
Y /(i
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Yl
Will ere 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
Y G
Is parcel 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
on public water and sewer?
YJ/ N
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit ##
Will -there be any new construction or renovations?
If so, obtain a ro r Permit. �2
Permit #
Is /
Is thTf or sales of Fireworks?
If so, obtain a copy ofF/R permit.
Permit #
U/N
If sp, List•
jgj6�LgpKa e
.R r
Y.
N
so, List:
Rev lewer to compWe the loftwing;
aam footage of Use; L-3 05
90-8105 Fine 3 of A
iJndcr°ectian; Z5A
Supplemcutary regulations seetion:
Parking formula:
Required spaces:
Y/W
ltms to he vcrified in the fitld:
Inspector Marne & Di2w:
Antes
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