HomeMy WebLinkAboutCLE200500281 Action Letter 2017-08-03Application for Zoning
Clearance
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[Zoning Clearance = $35
OFFICE USE NLY
CLE # " - g
Check # Date; b
PLEASE REVIEW ALL 3 SHEETS
Receipt # Z . Staff:
`ARCEL INFORMATION
ax Map and Parcel: rr—_ _ `7
_ Existing Zonin • r�
reel Owner: e &.X)w U-C,
Parcel Address: _aan -Itf� IE�S .
City gn6W!M&S j State i✓ o
Zip ZZI J
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APPLICANT INFORMATION / ��
Who em /LAn
should we call/write concerning this project?
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Address :___3p t-kaeai PW Ofe. 5o/
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zip !`,
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Office Phone: ( ) L2 -Q0W_ Cell # $PG - $Y '" Fax # ! E-mail ¢)ytst tl l% [Q &
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ROJECT INFORMATION
usiness Name/Type:b/bt� revious Business on this site:
Proposeduse:Gt-
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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.
1 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 ffOw(I� S
APPROVAL INFORMATION
( ) Approved as proposed kVApproved with conditions
Building Official
Date---1"r16�s�5_
Loning Official Date 1
Other Official �Date
County of Albemarle Depa community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 2%-5832 Fax: (434) 972-4126 'ot a '
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;
b) 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 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 'i.:J 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 f& 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.
/ N Is the parcel on public water and sewer?
Y UWill you be putting up a new sign of any kind?
If so, obtain proper Sign permit. Permit #
14 Will there be any new construction or renovations?
If so, obtain the proper Permit. Permit #
C-��
Y !/ Is this for sales of Fireworks?
�� If so, obtain a copy of FIR permit.
Zoning Tech to complete the following:
Violg
ns.
Y IIf so, List:
Va e:
Y N If so, List
Reviewer to complete the following:
Square footage of Use:
2goC)1(-
Permit #
Pro
i s:
Y / If so, List:
Y /f N ) If so, List:
Permitted as:
Under Section: 29A .2 , 1 Supplementary regulations section:
Parking formula: zM 4 4P 566 -L2 Required spaces:
Y 1, Items to be verified in the field:
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