HomeMy WebLinkAboutCLE200500276 Action Letter 2017-08-03Oh af.fu.
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Application for ZoningClearance
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OFFICE USE ONLY ^� �
oning Clearance = $35 CLE # iJCJJ O
PLEASE REVIEW ALL 3 SHEETS Check # 7 0 yr Date: Q
Receipt # Staff.•
PARCEL INFORMATION Cb
Tax Map and Parcel: 0,�[/,0 !00 40 V 30D Existing Zoning
Parcel Owner: /4o (Li rylR_, a1 -Li/'1 Can 4,- LLG
Parcel Address: 8I0(1 c Si-4 CL 6 ",3 city f)'trJ Ak-State V'*_ Zi
-nclude suite or floor)6N_1?4y. •----------
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PRIMARY CONTACT
Who should we call/write concerning this project? pe/1.4110p-fin �n - ,Oo �g r.:s
Address: Slro,3 1 Zra r, 61,4v.1 AV,* City lam.bam'n" State too _Zip ?gdIr
Office Phone: (5q0} Zq3 97 e0 Cell # ;, 60-.2707 Fax #,3y3. S%T3q E-mail
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PROJECT INFORMATION
Business Name/Type: KO C L T c- O V-" a m
Previous Business on this site: rLD,4.4
Proposed use: X &A O v.t a w..- �A� r to
Circle (if applicable): Fireworks / Christmas Tree
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SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS 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 owners permission to use the space indicated on this application. I also certify that the information provided is
true and accurate to the best of f my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature " /I►tl� Printed �y ✓L -max EI % -v^
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AP OVAL INFORMATION
Approved as proposed [ ] Approved with conditions
[ ] ackflow device and/or current test data needed for this site. Contact ACSA 977-4511, x119.
[ ] No physical site inspection has been done for this clearance. Therefore, it is n:irtaliriRb omp r ce with the existing
or
site plan. 13aCkfJov" Devke *Id
[ ] This site complies with the site plan as of this date. C>aMat Test IDD N PA
...� w n'77.d511. 1119
Building Official Date .��� r o ,w
Zoning Official Date 01 7.6
Other Official Date
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VUA
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fast: (434) 972-4126 10/14/05 Page 2 of
Applicant to complete the following:
N
you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
DY N
D 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.
Zuni
Y
If
9A49ancr:
V N
f so, List:
the tol
Intake to complete the following:
Y /Q
Is use in LI, HI or PDIP zoning? If so, give.applicant a Certified
Engineer's Report (CER) packet.
iiZyN
�ill there 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/0
Is parcel on private well and septic?
If so, give applicant a Health Department form,
Zoning review can not begin until we rec ive approval from
Health Dept. FAX DATE
U / N
on public water and sewer?
O/N
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit # � �!
I
I�/N
'Will there be any new construction or renovations?
If so, obtain the pro er Pe/rm/it.
Perniit #
YI'QIs this or sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
N
I- MA- - 1113
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2_M — 2L& 4 ni 4
YJ/ N
so, List:
57�—']-401 - 068
sue- I - D la q
6.
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10/14/05 Page 3 of 4
Wviewer to Complete the Fallow iILg
.,;t7uarL Poatige0fLr5w_ I.CiSQ
611 N
Permitted as:
v
Under Section:. 2 . 2 - I b
Supplementary regulations section:
Parking formula:
Required spaces:
Itemgbe verified in the field:
Inspector Name & Date:
Notes