HomeMy WebLinkAboutCLE200500312 Action Letter 2017-08-03Application for Zoning Clearance
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OFFICE USE ONLY
Zoning Clearance = $35 CLE # Zoos —3 /
PLEASE REVIEW ALL 3 SHEETS Check # e9a q 3 Date: IQ
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Receipt # Staff:
PARCEL INFORMATION 'z / -3-06 Lor
Tax Map and Parcel: 8 p to \ \1- Ati Existing Zoninu /v M p
Parcel Owner:
4�►y 61en WzoC1 S' CAV!, 0n
Parcel Address: ca tt V__ , Sta i e_ 'a.Cay City 0ti We- State Zip a,'a,Ci G�
__ finclude suite or floor-
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PRIMARY CONTACT
Who should we call/write concerning this project? TS)rm
Address: Q qy \k S�R v e p__* City (,l yxy% U C ` Statey G Zip 1,4A 0'5N
Office Phone: &6& 3'a+'6�e5 Cell # Faz # aei6- 3�F0\ E-mail ( ymzsAV,A
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PROJECT INFORMATI N ,�` jj 1
Business Name/Type: � Y I A p tr'1� T4 w.�s 1L\_/_lam 17
Previous Business on tors site:
` TProposed use: DEC 0 5 2005
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 K Printed VA LL� rdt 0'c C.4A
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AIPPROVAL INFORMATION
Approved as proposed [ ] Approved with conditions
[ ] Backflow device and/or current test data needed for this site. Contact ACSA 977-4511, x 119.
%'0-
[ ] 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. I ,88CM0. Device.nd%r
Building Official Date o
Zoning Official Date — 01 �o171 aC06
—�
Other Official
Date
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iemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 10/14/05 Page 2 of
Applicant to complete the following:
Intake to complete the following:
QI N
you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
0/ 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 location within the
structure.
Tech to complete the
Y
If
Va e:
Y L"'
If s' :
Is us in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y
Wil re 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!
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
'/ N
on public water and sewer?
Y It
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
Y /Qhere
Will be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Y/6N
Is this for sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
�1 N
so, List:
10/14/05 Page 3 of 4
Rtxiewer to complete the following.
f
YIN �_r- %
Pcrrnimd :is: TIP* SS.[ � V1 � � tT�Cz
Linder ecIion; A.
guPrlCmentl y tegulaliuns lion.
pa*ing formula, �• S tCR. ' 7=55:F � `1 14214X ' f4 = 7 c3
Required spaces: -7 su s
Y IQ
ltcros to bC vcTi ied in N! field,
lusp"tor Naine & date:
Notes
10i I4+0.1 Pot: 4 ol`4