HomeMy WebLinkAboutCLE200500297 Action Letter 2017-08-03Application for Zoning Clearance A �; &'
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OFFICE USE ONLY ,.
❑ Zoning Clearance = $35 CLE #f
PLEASE REVIEW ALL 3 SHEETS Check # Date: J
Receipt # Staff: D
PARCEL INFORMATION - -1f-Qf Q
Tax Map and Parcel: 4�) (o l AA O - Od - 1 a " Q 01 8 2 Existing Zoning r MAC
Parcel Owner: 4 ,eW ., Pon5 L�- Of 50.rlo(Cc,
Parcel Address: R cL.( G rcl-e- City Ck�arLof eenil, state \),A _ -zip 2zq
(include suite or floor) _
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APPLICANT INFORMATION
` ,Who should we call/ t� ce`rni g this project?
/Address : DO )vcl L"- City_L�cyW'kNA state VA
p
i� Mee Phone: (�{3y) Q`1-3 �Sg� ll # 94P-&eZdFax # _E-mail RGi �s3�9[� hod rr+a� .Gent
---- -- --------------------------------- - --- ---- ---- -- - --------------------- --- -- ----------- ---- - - -
PRIMARY CONTACT
Business Name/Type: r�-1C,�,n ��i e n •� la tom- �t 1� C in-�1, i Yr my-)i j Nis 0-100 L
Previous Business on this site:
Proposed use: Me,i+nsl Adl S 1=2i, L
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 of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature
Printed
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APPROVAL INFORMATION
[ ] Approved as proposed &5i1pproved with conditions
o physical site inspection has been done for this clearance. Therefore, it is not a determination �n�e wltb the existing 4�N
site plan.Current Test Data Needed
[ ] This site complies ith the site plan as of this date. Contact ACSA 977-4511, x 119
1 r -61 If i if If A 1
Building Official Date
Zoning Official Date ( /1 15/65
Other Officiai Date
'County of Albemarle Departmentof 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:
Y N
96 you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
fo
1N
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; 3 t 0-0 5�- v'
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.
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s1. Fr
toning Tech to
Vio ons:
Y
If s st:
the
A (�
Varce•
If so; List:
Y /O
Is use in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y/N
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
Y / 0
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
O/N
Is on public water and sewer?
@/N
Will you be putting up a new sign of any kind? If so, obtain
proper Sign ertni
Permit #
YIN
Will there be any new construction or renovations?
If so, obtain the
�ppro/p�err Permit.
�
Permit # a l _7 . � ,ig1j
Yl�
Is this far sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Pro
YI
If so, ist:
SP's•
If so:
Reviewear to complete she falluWjng:
Squaite rootage of Use' -- 7 $ O 96
.2 0(4
' V/N �h
Permitted as:
Under Section: _ate , 2 - I --
upp1mentary rogaL-ftinns wctiop_
Parking formula: 12E:3.;k--
Required spaces: l>
Y l&/
ite f5tto be verified to thr field:
inspector Marne & Dale:
N of es
3/28/05 Page 4 of 4