HomeMy WebLinkAboutCLE200500286 Action Letter 2017-08-03Application for Zoning Clearance
OFFICE USE Y
❑ Zoning Clearance = $35 CLE # D
Check # Date:
PLEASE REVIEW ALL 3 SHEETS Receipt # 55662r& Staff: /JIA 77
PARCEL INFORMATION r� � p p
Tax Map and Parcel: 00Q2 -0 Q0 +�1 E Existing Zoning Tl i J
Parcel Owner:��
Parcel Address:
City State
07.
- nclude suite or floor
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APPLICANT INFORMATION
Who should we call/write concerning this project?LL' - _
�tA (2 LOZt-F A}E L--m_6 1
Address :� O, 7-16 City CL_-ate V
Office Phone: f Z Cell fh & -- i h0J Fax # E-mail �-
PROJECT INFOI
Business Name/Type:
Previous Business on
Proposed use: � CX_A_� AA CK_t_ `, r�
Zip'22E1 9'
Circle (if applicable): Fireworks / Christmas Tree
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet3)
*This Clearance will only be valid on the parcel for which it is approved. if you change, intensify or move the use to a new location, a new Zoning
Clearance will be required.
I hereby certify that I own or have the owner's permission to use the space indicated on this application. I also certify that the information provided is
true and accurate to the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Sig Printed (.'"PfL Lo Tt-F— �' S F�`C CVQ�� 71
APPROVAL INFORMATION
($r) Approved as proposed
( )e,) Approved with conditions
Building Official Date 0'
Zoning Official Date
Other Official Date
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County of Albemarle Department of Community Development ,r�/d~i
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-412
Applicant MUST HAVE the following information to apply:
1) Tax Map and Parcel or Address with unit number or floor if appropriate.
2) 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 / N 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 /L"% Will there be food preparation?
If so, fax application to Health Department. FAX DATE
Can not issue until we receive approval from Health Dept.
(D/ N 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.
Y 1 0 Is the parcel on public water and sewer?
Y /(5) Will you be putting up a new 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 this for sales of Fireworks?
If so, obtain a copy of F/R permit. Permit #
Zoning Tech to complete the following:
Viol�ions:
( /6 If so, List:
Vance:
Y i N ] If so, List
Y f N'1 If so, List:
SIP
Y n
If so, List:
Reviewer to com late the following:
l SDI& area, 5W 1 Kvf eow
Square footage of Use: 4 . criC?�' _ Permitted as: —',WIM S01 'C S
Under Section: '5P~ 200 3— 4--7 Supplementary regulations section: �r
Parking formula:
Y. & Items to be verified in the field:
Required spaces: