HomeMy WebLinkAboutCLE200500298 Action Letter 2017-08-03Application for Zoning Clearance � }n
OFFICE USE Oe
El Zoning Clearance = $35 CLE # (�
Check # Date:
PLEASE REVIEW ALL 3 SHEETS Receipt # Staff:
PARCEL INFORMATION ' ? _ ) 0 S
Tax Map and Parcel: O �� `} Existing Zoning
Parcel Owner: 1V o W y
Parcel Address: . „ ,A —
- —City State 0i Zip = 901
_____(include sulte or floor)-_
APPLICANT INFORMATION
Who should we call/write concerning this project?
Address • F a 6 O� b ba, City
Office Phone: t 1- a 116 - ',:�0 / -7Ce11 #
�45e, (J-s
'l(Lou(,�te.0 -A- ___ ZIP&_V__T�4
Fax # E-mail
PROJECT INFORMATI 7Na `',' �� 1
Business Name/Type: 0 ti t i d � F+
Previous Business own this site:
Proposed use:LA 7
Circle (if applicable); Fireworks 1 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.
` J
Signature cLj
Printed N 1 `� Sus
APPROVAL INFORMATION
( ) Approved as proposed
.4094proved with conditions
Building OfficialIzZN_
Date
Zoning Official Date
Other Official Date
.------------------- ------------ 0.--0..--... = - - -
County of Albemarle partment of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126
irarcwi ragc s u._ .
Applicant MUST HAVE the following information to apply:
1) Tax Map and Parcel or Address with unit number or floor if appropriate.
2) A 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 i N� Will there be food preparation?
If so, fax application to Health Department. FAX DATE
Can not issue until we receive approval from Health Dept.
Y I W 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& N Is the parcel on public water and sewer?
N Will you be putting up a new sign of any kind?
If so, obtain proper Sign permit. Permit # It
Y 1 O Will there be any new construction or renovations?
If so, obtain the proper Permit. Permit #
Y IN Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Zoning Tech to complete the following:
:I roomtr•I aRJ_,�
ariance:
UY 1 N If so, List
)�-p, - 11 W. , nGy�
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Reviewer to complete the following:
Permit #
91 N If so, List:
'7 -)-)
-
P's:
1 N If so, List:
SP_-?AAC-.
SP- 111(.- 02-1
Square footage of Use: Permitted as:
Under Section: Supplementary regulations section:
Parking formula: Required spaces:
/ N Items to be verified in the field: