HomeMy WebLinkAboutCLE200600101 Legacy Document 2014-07-22i
App'l canon for Zoning Clearance
OFFICE USE ONLY
Zoning Clearance = $35 CLE #�
Check # el 599
PLEASE REVIEW ALL 3 SHEETS Receipt #
U �!i-• [T7
Date: 4 - R7'-O .
Staff:
PARCEL INFORMATION G'
Existing Zoning
Tax Map and Parcel:
Parcel Owner: /J k fi'/ " v "
G city /�,�i� i� /G�State - - - - - - -- - - - -- -- Zl -
�l 93 SE�i�o _ y , .�i.� p
Parcel Address: ,
include suite or floor) -
APPLICANT INFORMATION
Who should we call/write concerning this project?
Address
/ /9!S S�iGl�it/U! ' City - #,f s zA a State t�Glit' /fi Zip
/� E -mail
Office Phone: q l rq 3 33 Cell # r� s- Fax # ��—
-�- -------------------- - - - - -- - V - -- - - --------------- - - - - -- -- ------------- - - - - -- -- - - - - - -- r
PROJECT INFORMATION �t d
BusinessName/Type: d,�D�tm /4/- -? ��i%Li� -S'
Previous Business on this site: -
CIL
Pro o d se use. #-I- i
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 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.
S igna
/ Printed��
APPROVAL INFORM ( ) Approved with conditions
( ) Approved as proposed
Building Official
c Date 5- 16al,
Zoning Official �—
Other Official
- County of Albemarle Department of Community Development
Applicant to complete the following:
Y/N
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 location within the
structure.
Zoning Tech to
Vio 'ons:
Y N
If st:
/ N
so, Li t:
the
Intake to complete the following:
Y
Is u m LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y
Wil ere 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 pareef 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
Y
on public water and sewer?
Y
Wi� be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
Y/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Y
Is this or sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Y/
If sc
SP's:
Y /
If so,
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