HomeMy WebLinkAboutCLE200500294 Action Letter 2017-08-03Application for Zoning Clearance
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OFFICE USE ONLY-
❑ Zoning Clearance = $35 CLE # }
PLEASE REVIEW ALL 3 SHEETS Check # Date: -
Receipt # Staff:
PARCEL INFORMATION
Tax Map and Parcel:
Parcel
Existing Zoning MI 1 i I
Parcel Address:6m E. Nux1 si m CityWqlp State h . Zip QV
----- (include suit-- o�or) -- -----------------------------
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APPLICANT INFORMATION p
Who should we call/write concerning this project? L<S A, AMR zron e-S Ap"10, Pry+a1 -
a Address : �u f�' r-�a� Pit,, w, city
Office Phone: L_) Cell # Fax #
State U Zip ?= 'V (
E-mail
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PRIMARY CONTACT
Business Name/Type: h.cr rc-•c+' - �'%��-;�v, , e �cr�J .
Previous Business on this site: IVC L%J C ok'54`yC.5--to
Proposed use: R ; `L C')C_C'-C e_ I e xPV_' R_a u e- S
Circle (if applicable): Fireworks / Christmas Tree
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 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 knowledge. I e read the conditions of approval, and I understand theme, and that I will abide by them.
Signature Printed 'C r-e. !.>~n (SbA Pto 7q 10,))
1000,
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AP,PROVAL INFORMATION
[Vj Approved as proposed [ ] Approved with conditions
[ I ] No physical site inspection has been done for this clearance. Therefore, it is not a det � l rft exi ting
site plan. a
[ JA This site complies with the site plan as of this date. G1iffwt Test Data Needted
Contact ACSA 977-4511, x 119
Building Official Date
Zoning Official Date
Other Official 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
9M/05 Page 2 of 4
Intake to complete the following:
Applicant to complete the following:
P0Y
N
ou have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
l x )/ N
o you have a FIoor 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.
Soning Tech to
ViolqtiQns:
Y 1 jN�
If so, ist:
Van' ce:
Y/Ni
If so, fst:
the
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use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
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Will ere 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_
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Is parcel on private weII and septic?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from
Health Dept. FAX DATE
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on public water and sewer?
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Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
IN
ill there be any new construction or renovations?
If so, 01
e er P
Permit -
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Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
SP's-
If/
Ifs Est:
9128105 Pie 3 of
Reviewer I mmplele the rollowill g.
Square footage or Use: / � 60
hfb'itted as: m-U,= $
Under Section: S , 2 . 1 f
Supplementary regulations section:
Parking formula: .�,,.,��Qn.� Zoof P Sd��
Required spaces: p�
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Iteres to be verified in the field:
Insperinr Name & Date;
Nu Ilm
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