HomeMy WebLinkAboutCLE200500330 Action Letter 2017-08-03Application for Zoning Clearance
❑ Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
PARCEL INFORMATION
OFFICE USE
CLE #
Check #
Receipt #
Tax Map and Parcel: - D(JCJ Existing Zoning 94 _-
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Parcel Owner:
Parcel Address: 1 ¢ : 1^ l; Ci a
ty State Zip
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�n elude suite or oor
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APPLICANT INFORMATION
Who should we call/write concerning this project? I
Address: t City li State Zip9-4-5-2
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Office Phone: ![� Cell # Fax # /"1" E-mail �0 i`!� �� •
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PRIMARY CT
Business Name/Type: h Z �,, � [te ft2 it k�P+- , t �
Previous Business on this site:
Proposed use:
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 anew location, anew 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 tqtthe best of my knowledge. I ave read the conditions of approval, and I understand them, and that will abide by them.
Signature ' µ°' Printed ' ! (�
t
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APPROVAL I1�IFORMATIO�
[.6]'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— i l l b t a c
Zoning Official Date
Dther Official Date r
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b Albemar a Departlfhen Of mmu>�i Develop ent
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
intake to complete the following:
Applicant, to complete the following:
o you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
YIN
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.
'oning Tech to
vio ns:
YIN
If so, -List:
var- nce:
Yl
If so, Est:
the
Y /CN?
Is use in Li, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
s►Y I N
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
'Is parcel on private well and se t'
'�iv applicant ealth Departmen orm. '•� �n
Zoning review can not egin n we receive approval from CP
Health Dept. FAX DATE 1 —L9 -bi,o ',
Y /W
Is on public water and sewer?
Y / 1
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
Y l
Will ere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Y/N
Is th`tfir sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Pro s:
YIN
If s t:
SP'
Ifl
If so, t:
rceviewer to cnrnp.,ete mi! tom uwai
squam
Ferrrirted as; �-�
Under Section.
Supplementary regulations section:
Parking formula: 15MELz4r, i 0 d gr�&t
Roqu imd spaces:
(a r7
Y I 1
Itc o be verified in die field:
Inspector borne & NIL :
Naes
v,,, - is E eed � oa05iz
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