HomeMy WebLinkAboutCLE200500305 Action Letter 2017-08-03Application for Zoning Clearance
❑ Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
OFFICE USE
CLE # i
Check #
Recei t # -6�
vim
1, (1 1U
PARCEL INFORMATiION �l 1�
Tax Map and Parcel: _ DJb14o2 -0/ `� r 0 a�0y Existing Zoning Lam] r
3
Parcel Owner:_ �Y'o Z L� ShD,0001fVQ `-'_�7'e r 6ngAR )C1Vq I�OTJ �Ze_� -lid
Parcel Address: C ry zG7 �j4 /
hAr . A); r city . Q ra z eT State V �`� ZiA� 93
____(include sui a or flo )_
APPLICANT INFORMATION C nn
Who should we call/write concerning this project? `, t r
Address : 'p. D I Rol 1 / 6'1 City
Office Phone: } 4�Jr— 702 Cell #
PROJECT INFORMA'
Business Name/Type:
Previous Business on this site:
State U -A Zip; 0'0
Fax # E-mail
Circle -(if applicable): Fireworks / 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 1 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.
5
IN
Signature S t Printed � 11" /-,e a . s �1 A) S
-------------------------------- 4 -------------------------------------------------------- / ---------------------- I ---------------------------
APPROVAL INFORMATION
( ) Approved as proposed ) Approved with conditions
Building Official Date_( Flo -s'
Zoning Official Date ►
Other Official Date
--- -• ---- ---- t- ---........... ...........................................................
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126
2 of
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;
orb) 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 1 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 1 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 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.
OY / N Is the parcel on public water and sewer?
Y l lr
Will you be putting up a new sign of any kind?
If so, obtain proper Sign permit. Permit #,
Y ! V Will there be any new construction or renovations?
If so, obtain the proper Permit. Permit #
Y / 0 Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
' Zoning Tech to complete the following: I
-�
1 a i i�b CbUm= AZ
FaA
■r:�
Var' ace:
Y 1 N If so, List '
Reviewer to complete the following:
Square footage of Use: As S 64-'_
Under Section:
Parking formula:
/Items to be verified in the field:
SP's:
Y / If so, List:
Permitted as:
Supplementary regulations section:
Required spaces: g-a AAww-