HomeMy WebLinkAboutCLE200500295 Action Letter 2017-08-03Application for Zoning Clearance
❑ Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
PARCEL INFORMATION
Tax Map and Parcel:
Parcel Owner:
Parcel
OFFICE USE ONLY
CLE #
Check # Date: -IL l't, Ub
Receipt # Staff:
cis it�fk
Existing Zoning.._ P We
State VLA • Zip 101
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APPLICANT INFORMATION
Who should we call/wrlte concerning this project? 7-lbmpC5, bwih ow4
Address: 671 WrlyPK- GULF _City CState VA Zip b2fk,/
Office Phone: (�-9) &I ?4-t¢17 Cell # JW 4-ZAP Fax # 1741776 E-mail 1 i neDJn Surw;j M P
wliwASPfz1,H4. 44-1
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PRIMARY CONTACT
Business Name/Type: l � bm !3, Li eo L?oqp0 Su t!nr
o� 1 M C
Previous Business on this site: ?�(> + SPA ,�rz4-pnt, 671bI?e—
Proposed use: I—i.,,m0 - �,u 1(ZUf `yo 12-- Dir-i
ele
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 b owledge. v ead the conditions of approval, and. I,unndde'rstand them, and that I will abide by them.
Signature Printed 1 2!_4 F6 UMW W _
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APPROVAL INFORMATION
[ ] Approved as proposed j�Vpproved with conditions
[ ] No physical site inspection has been done for this clearance.
site plan.
[ ] This site complies with the site plan as of this date.
Therefore, it is not a determination of compliance with the existing
Backflow
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
Intake to complete the following:
9/28/05 Page 2 of 4
Applicant to complete the following:
/N
o you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
g/N
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; S107 SF
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 /@
Is use In LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y
Wil 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
Y/N9
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
IN
on public water and sewer?
Y
Wil you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
-willN
lIl there be any new construction or renovations?
If obta �r Moe Permit #
Y/N
Is this for sales of Fireworks?
If so, obtain a copy of FIR permit.
Permit #
Soning Tech to comlete the
Vi ns:
Y I N
If s , sst:
Y
If
Var n Sp';
YIN Y/
Ifs . L' If sc
9I2M5 Page 3 of 4
Revlewtr to cumplety the roHowiog:
$qv#m footage of Uw
TIL=111CL! as:
Under Section:
u�a�lerrMcr�tary regt�Jnticxis.sr�ti�sn=
PArking formula; l�ss,�.se. SF�.BL`!•
r
required spaces'
Y
h€ s to be verified in the fie1r3:
Inspector Name & DaIe: