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HomeMy WebLinkAboutCLE200500301 Action Letter 2017-08-03Application for Zoning Clearance Oil 0, 4 D TIC &L" %� OFFIC U E ONLY ❑ Zoning Clearance = $35 CLE #% l PLEASE REVIEW ALL 3 SHEETS Check # Date: Receipt # 8 Staff: PARCEL INFORMATION 0 F �� _ ss Tax Map and Parcel: ® L CVO -00 ­0®`O L31 Existing Zoning 1-' D M C Parcel Owner: l [I,-,0 � r J 1� Parcel Address: 0 PAL/ 1 160tity State A Zi (inc ------------------------- -ludesuiteor floor)------------------------------------------------------------- ---------------- APPLICANT INFORMATION r ,.� + ,j , Who should we call/write concerning this project? Z—eA ,N'OVW 1C'ej Address: GOD t�e}�+ - `�� City hC+�r �- os(.a�� _ State U A Zip ,Z A I 1 o Office Phone: %V Z.3 N©CeII # Fax # E-mail ---------------------------------- PRIMARY CONTA Business Name/Type: .r.,-L.-_ Sv Previous Business on this site: N ��•.J L p►.� t�..- Proposed use: ©t- rto e7.G,,01-% ?40 W! - 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 Cleamnce 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 tree and accurate to the best of rp wledge,ve read the conditions of approval, and I understand them, and that I will abide by them. Signature Printed le- ---------------------- - ----------------------------------------------------------------------------------------------- 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 site plan. [ ] This site complies with the site plan as of this date. Building Official Date 6 Zoning Official Date f o7 6 Other Official Date ------------------------------------------------------------------------------------------------------------------------------------------------ County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 9/28/05 Page 2 of Applicant to complete the following: Vo N you have one of the following? Tax Map and Parcel Number and or; Address of use (include unit or floor if appropriate; Q / N o 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. Soning Tech to complete the Vio ons: If l Ifs , xst: Var' ce: Y/ If , ist: Intake to complete the following: Yj/ N s use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. W Will 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 Y Aq 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 'Yy N �s on public water and sewer? Y �N Wil ou be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Fvff N %11 there be any new construction or renovations? If obtain the proper P Perr mit # r j Y /i Is this for sales of Fireworks? If so, obtain a copy of F/R permit. Permit # Pro Y N If s , ist: Y If 912SM5 Pau 3 of 4 Re4iewer.to c€►mplrte the following: Square footage of Use; 2 1 14 Undar Section: Supplamenmry regiolatians section: Parking fonnula. l 1 " Required Sp&CeS: Y/N hems to be vnrifirrd in the field. Impaefor Name & Date: Norte 3I2W Page 4 of 4