HomeMy WebLinkAboutCLE200500315 Action Letter 2017-08-03Application for Zoning Clearance
10
ONLY
[ Coning Clennnee =.Ws �cLE `Z-00
PLEASE REVCEW ALL 3 SHEEP'S Check # z 0.&_ Date; - 7.. 0
PARCEL WORTION
Tax Map and Parcel: ' ` , v Ex�ng Zo Z
Parcel Qwner: NC�if`--�1,(r-:n � ,�, � ,nn r,.,� .�
Parcel Addrm: no I 1001-g- city '2 r 1 r-,1 iI -State ti Zi i l
- (incla�ie st fe or noor�
APLICAN`I' INF)ll'iTIN ---------------- - ------
--------------------- ------ --------f---------
Who shonid we calllwrite concerelag tkis propa ? (`}� �} '+" ' L ( - T5
Address
'r , Je- C� CO f L State rN'1
Offte Phone. 7 r3 t l 5 i Call # 410— 3L, 5- . - Fax # LIi 1). E-imaII f1 a.S h ��
RM ItY C0�'A- CT ------------ •- ------- --------------------- ------------ ------------ --------- --------------------------------
Bnsiness Namel'I'pe; A f, � ryt M (I r\ 1 (—q-r\ i 40 f ^ o —I-
Previous BUENOS on this srtc:
Pr posed tree• Q �1I pr
t Q �wf 1ic� 1�i
g
Circle (if eppli le): Fite+ flm I Christmas Tr"
SEE CONDITIONS OF APPR0,VAL IF THE CI.F,ARANCE IS FOR pMEWORK OR CMMTMA5 TREE SALES (Sheet I)
*Thu Cll=mw wM only dbe valid on the parcel for which it is approved- If You change, int0mifY or move the use to a now locaflm% a neww Zoning
I Wcby certfy that I own or haw the ownees permission to use the space indicated on this application. I also certify that the fdarngtion provided is
true and accurau.tqthc best of rn ldibwledge. I have read the conditions of apprnvai, Wo I undaVand them], and that I wtl, abide by them.
5igaadare � �, -
rrktted
.------------------------
PROVAL 'ORMA'ITON - _------------------ ....---------------------- -------------- -.......... ---------------------
C ) Approved as proposed [ 7 Approved with coadtons
C '7 No lhyskW site inspwdon has been done far this c eamce. Therefore, it is not a do wmfiladon of compliance wi& the
sexistsng
ite p1an.,
f ] This stte complies with die site plan as of this date.
Bpildiag Oftcial
Zoning Offidal
Other Offkial
Date
Date
Date
------------------- ---------------- ------------- ......- _
-- -----..�-------- ------------------------._..-------,-----------
All------------ ------
Cut o.M et-darle Department of Community Development
401 McIntire Road ChairlottmUe, VA 229ii2 Voice: (434) 296,5832 Fax: (434) 972-4126
SOO/ Od adZ[=Z0 900Z Z 3a0 SZGVUMV x23 [iN3Wd0W30 hilNKNOD
Applicant to complete the following:
W.carvJ rags Z of Al
Intake to compYete the Mowing;
X/M
Do you have one of the fallowins?
Max Map and Parcel Number and or;
Address of use (include unit or flew if appropriate ; y`>
Y/14
Do you have a Floor Plan (slceteh or an architectural drawhig) than
includes the fallowing, and if so please provide it with the
application?'
ne fatal square footage of the use attdlor; M, (}�
'Clle square footage of each room or area of use;
U." of mh mean or area
If using less time the entire suuctur% note the lowdon within the
struciure.
Tech to complete the
YIN
sn % `
r 7Q - rl 5
O ,v
r
-Xns6—M LI, HI or PDIP zoning? If so, give applicant a Ce1#ifW
]sneer's Report (05R) paekeL
YI
Will ere be food preparation?
If go, give applicant a Health Dgmr�ment form.
Zoning review coo not begin untkf we receive approval &=
Health DepL FAX DATE . --
y
el OR private wall and septic?
If so, give applicant a Health Deparlauent farm.
Zoning review can riot begin until we receive approval fmn
Realth Dept. FAX DATE _
�!N
is on public water and sewers
y I�
W' YOU be putting up a now sign of any kind? If so, Obtain
Permit #
i r
'4V" ere be any now constructio,a or renovations?
If so, obtain the proper permit.
Permit #
Y
Is loor sales of 1; fireworks?
If so, obtain a copy of FIR permit.
Permit 9
ropers:
/N
so, List;
A-
r
4
/N
so, U=
- 6!;q
90O/VOOd adZ['ZO 5OOZ Z 090 9Z[VZL6D£q xa3 L1N3WdO13A3Q A11Nfmo
F4.cvicWer to compiele The Fnllowing:
Square Fanlage orUse-
911-8/05 paRe-3 of
YIN
Permitted m.
[Under Section;
Supplbmmtary regulations %Or ion:
Parking formula:
Required spaces:
YIN
Items to be verified in the field:
Inspedur Name & DHie:
Notes
3f78/05 page 4 of 4