HomeMy WebLinkAboutCLE200500264 Legacy Document 2014-09-09Albemarle Count Department of Community Development 05 CK
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Application for
Zoning Clearance
Tax Map /Parcel: '75 / 33
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• Parcel Owner:
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C o Address 2 S cam. tn�o,�d•
(Include suite or floor)
Who should we call/write concerning this project?
o Address J,' ►1 tJ
Q c Office Phone:
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Fee of $35.00
Check #
Recept #
File #: V5-,,f-
Date:
Staff:
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City State Q • Zip
Existing Zoning: 4C
City m-`IL,C ar J State �Q • Zip 2Zg5 q
Cell: 5�3 11 � �
Fax: E -mail:
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Business Name/Type:
Previous Business on this site:wp —
Proposed use:
Circle (if applicable): Fireworks / Christmas Tree
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'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 owners permission to use the space indicated on this application. I also certify that the information provided
is true and accurate to the best y knowledge. 1 •have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed .__/Q�'l�( f�
.------- - - ---- ------•-----•---•--•------- ••-------- •------ ......-- - - - - -- ....-•----.......-------------•---------...--------.-----
( ) Approved as proposed ( ) Approved with conditions
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a Building Official Date
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Zoning Official (32o s •-56g2gC- Date I a'�lalas-
Applicant to complete the following:
N Do you have one of the following:
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
OY / N Do you have a Floor Plan (sketch or an architectural drawing) that includes the following:
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.
Intake to complete the following:
Y /O Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet.
Y / 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.
Y /UN 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.
oY / N 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 #
Y/ N Will there be any new construction or renovations? If so; obtain the proper Permit.
Permit # ���^�- fte
Y Is this for sales of Fireworks? If so, obtain a copy of F/R permit.
Permit #�
Zoning Tech to complete the following:
Violations: Y /(Tl% If so, List:
Proffers: (' Y N If so, List:
Variance: Y /(N) If so, List:
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SP's / N If so, List:'
Reviewer to complete the following: Square footage of Use:
0/ N Permitted as: j�-S'"Under Section: ZLt , 2
Supplementary regulations section:
Parking formula: 4op9442$0'r -•2= Required spaces:
Y /O Items to be verified in the field:
Inspector Name & Date:
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