HomeMy WebLinkAboutCLE200500280 Action Letter 2017-08-03Application for Zoning Clearance;
OFFICE U !31NLY
❑ Zoning Clearance = $35 CLE # _ �Z-)0y
PLEASE REVIEW ALL 3 SHEETS Check# ffi2) Date: -�
Re #,6& 7_ Staff:
PARCEL INFORMATION GO —Ypc c KY--- tam
60
Tax Map and Parcel: "� y frog Zoning
Parcel Owuer.-��
rarcei address: %-j-16 :r:v i t RA _
.... _ _ Sinclude s to ar floor)_
PRIMARY CONTACT
Who should we caWwrite concerning this project?
cityckaf lo-tisudk State VA Zip 2:.9 0,3
Address: 211 k2ftCkW d Ln City -pA l
Office Phone: LJ Cen # - S S {, Fax #
State VA- Zip 3
E-man NDL1 t4 r:M4NAJiA[&EL
PROJECT INFORMATION ++ j
Business NamePType: Car b I u 1 G� n ✓t i
Previous Business on this site:
Proposed use: to
Circle (if applicable): Fireworks / Christmas Tree
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet 1)
*Thus 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 ownees permission to use the space indicated on this application. I also certify that the information provided is
trite 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 Les `1 T-' • l.U11
--------------------------------------------------------------------------- ---------------------------------------------------------------
APPROVAL INFORMATION
[ ] Approved as proposed [ Approved with conditions
[ ktyow device and/or current test data needed for thus site. Contact ACSA 977-45I I, xI 19.
[ No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing
site plan.
[ 1 This site complies with the site plan as of this date. Baekflow Device and/or
Building Official
Zoning Official
Other Otnciai
Date it
Date
Date
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County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 10/14/05 Page 2 of
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Applicant to complete the following:
(IN
)You have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor i€appropriate;
1Y/N
1-o 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 andlor,
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.
Y/
If sc
Intake to complete the following:
Y/N
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y&N
W . e 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 _ _
71,
Y'l%
Is parcel on private well and septic?
If so, give applicant a Health Deparunmt form
Zoning review can not begin until we receive approval from
Health Dept. FAX DATE
)f N
on public water and sewer?
Y N~
WiI you be putting up anew sign of any kind? If so, obtain
proper Sign permit.
Permit #
Y
Will there be any new construction or renovations?
If so, obtain the proper Permit,
Permit #
Y
Is t1Ets or sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
IQ -&AS •a3
Tech to complete the following: )� NO 5P.,14
V ce:
If
Ifs , I
YI
If sc
SP's•
Y TlIf st:
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I
'ff
10/14/05 Page 3 of 4
Reviewer to complete the following:
Square footage of Use:
� / N
Per,*nitCed as:
Under Section: ?�(, 2 , 1 �y►�
Supplementary regulations section:
Parking formula: 1 2 f $ .1 _z o = 4r;, 2
Required spaces:
Y
d to a verified in the field:
Inspector Name & Date:
Notes
10/14105 Page 4 of