HomeMy WebLinkAboutCLE200500293 Action Letter 2017-08-03Application for Zoning Clearance
❑ Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
PARCEL INFORMATION
Tax Map and Parcel:
OFFICE U ENLY
CLE #
Check # Date:
Receipt # staff..
Existing Zonin
Parcel Owner:
� s
Parcel Address: City U, State Zip
Q!nctude suite or floor) -------------------- ----------
- ---- -- --- - - - -- - - - ----g - - - - ---------------------------------------------------
APPLICANT INFORMATION .
Who should we call/write concerning thisproject? PtIt UL_
Address : r - O • i� o K_
�j f� (o City
�-Q� r' F S C-
State
Zip 2-4 5'5
Office Phone: (33 � -6 0Li
Cell # � '
Fax # S - L a 7-3
E-mail
-------------------------------------
PRIMARY CONTACT
Business Name/Type:
L-1 A v t. L.,) � < L.-r t (x" /V ,-� J
Previous Business on this site: N LJ
Proposed use: r 9 a l
0
--------- -----------------
Circle (if applicable): Fireworks / Christmas Tree
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet I)
*This Clearance will only be valid on the parcel for which it is approved. If you change, intensify ormove 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) the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature o---t ("'_ Printed � kUe- W �— `T t (s- �-, A
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APPROVAL INFORMATION
Approved as proposed [ ] Approved with conditions
[ No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing
ite plan.
[ ] This site complies with the site plan as of this date. 11 x `i Kt -L i fi 'Yov oeln03
Building Official Date slit O 6
Zoning Official Date S�[I za b
Other Official Date ll
------------------------------- ------ ---`- - -----�_iJ!_- ---- - -- �i'VekpM___
- - -- -------------
County of Albemarle Department of Commu ity
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
Intake to complete the following:
9/28/05 Page 2 of 4
Applicant to complete the following:
a /
N
you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
a
/ N
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.
ZoninL Tech to comDlete the followine:
Y 'Q
Is use in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y itN
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 _1111*5
Y/aN
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
public water and sewer?
VY j/ N
ill you be putting up a new sign of any kind? If so, obtain
proper Si
Permit it•
Y }/ N
ZI there be any new construction or renovations?
If so, ob a }t�
Permit # - Ij1
YN
Is t for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Vio h s: o#%rs:
Y N' Y / N
If s t: so, List:
zM & - 19 �G -�'2-
A At 2
arisnce:
YIN
so, List:
�I N
so, List:
So-
_56r V
_ P— 1 —biD��
C — Z6 r bC
69
w
r
9/21VOS Pape 3 o f 4
Reviewer to camp We the following:
Square footage of Usk:
Lr r r
1ermfttwd as: �Lotfi`-�s-IoIA®I Ss
Under Section: RSA 30
Supplementary raguiations sectivn,, 'r
Parking furaiu is: S I P /LGI — ��tl C r�l Vt (^°° P Pt &n(&I.XL V- )
�
RegLl d spaces: L i
Y
Items o be verified in the field:
IlUpector Name & flale-
Notes
1128105 Pagim 4 of 4