HomeMy WebLinkAboutCLE200500311 Action Letter 2017-08-03Application for Zoning Clearance
OFFICE USE ONLY
❑ Zoning Clearance = $35 CLE # -zoos -- 3 / 1
PLEASE REVIEW ALL 3 SHEETS Check # la2
1 t4 Date:-- -D,
Receipt # Staff:
PARCEL INFORMATION j Z - t 3- 0<
Tax Map and Parcel: _ _Th? Ice ;A), 33 /4 Existing Zoning
Parcel Owner:
Parcel Address: V 51
City _ [_1vs.1p % In C State
a •
______________ (include suite or floor) -_
----------- -----------------------------------------------------------------------------------------
APPLICANT INFORMATION -
Who should we call/write concerning this project? �.
Address: s S� hWC01-4� • �I .
L
City t�D State
Office Phone: L_) q79 441q Cell # ,:�N - III T Fax
E-mail
----------------------------------------------------------------------------------------------------------------
PRIMARY CONTACT , 1 16- -�
Business Name/Type: ,>t0* Q., TOt
Previous Business on this site: 5&-M ,2,
Proposed use:
Circle (if applicable): Fireworks / Christmas Tree
6
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 a of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature L Printed✓� +�
-------------------------------------------------------------------.-------------- --------------------------------------------------------------
APPROyAL INFORMATION
[ ] Appfioved as proposed [ pproved 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 t l -'L �'a s
Zoning Official Date /21/ 3 �0 S
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 4
Intake to complete the following:
Applicant to complete the following:
YIN
Do you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
Y/N
Do 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 Iocation within the
structure.
Tech to complete the
Y /Q j
If so, tst:
Vari
Yce:
I
Ifs .
YIN
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
YIN
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,)/ N
s 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
YIN
Is on public water and sewer?
Y/N
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
/N
Will there be any new construction or renovations?
If so, obtain the proper Permit. F-%C-
Permit# ZcoS- S?Mj� _ ✓IJ4 '
YIN
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
YN
so, List:
2- Wr -! to -
7—A6A 1191 -
-7 Aa I jjI — 0 20 —
7sY/N
o, L�'st:
S I n 3 ---=
12-8-0r
Rev fewer to tomplate tl5c follow ipig;
Squmm innEagc of Use: �t�
91,8105 Pare 3 of
Q' N _
Purmittad as;
SupplcMentary regulatimn scction_
Parking farmuW n« 'a[se ¢ �� d f • Z ID b
Required spaces.
Imms to be vcrifed in the field,
Inspector Marne & D21e:
Now
'OFev0
�eOF
3 SM5 page 4 of 4