HomeMy WebLinkAboutCLE200600233 Legacy Document 2014-12-02�ll.. licatien fOr Zolling Clearance Ja�_iT4-
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1J OFFICE USE ONLY
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Zoning Clearance = $35 CLE # (�
Check # �_I. Date:
t Staff: �.
PLEASE REVIEW ALL 3 SHEETS Receipt # —�-
PARCEL INFORMATION
� � Existing Zoning
Tax Map and Parcel:
Parcel owner: .�,9V
SCJ&# A ' tate rip S
Parcel Address: //tlOL� 7G Cit y
_ -, =-
(inclu-de -suite or floor) -------------------------- - - - - -- - - - --
-----------------
--------------------------- -------- - - - - --
APPLICANT INFORMATION
Who should we call/write concerning this project?
Address
%�9'.S S�lGI /it/U! -� %^2i� /L. City �1� State / / /t�G /�r' /A Zip"���
Office Phone:
3 Fax # i E -mail
PROJECT INFORMATION
Business NamelType:
V�
Previous Business on this site: 7—
Proposed use: T
�1 _Illy
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.
1 hereby certify that I own or have the owner's permission t oval, and I undlerstand them, and that that
l w 11 abide byathe provided is
true and accurate to the best of my knowledge. I have r ead the conditions of app
Signa ` Printed(
- - - -- - ------ ------ - - - - -- - --------- - - - - -- - -- -- - -- -- - - - -- -- - N-1p APPROVAL INFORMATION ( )Approved with conditions
( ) Approved as proposed
Date
Building Official
Date
Zoning Official
Date
Other Official
•--------------------- - - - - -- - - - -- --- - - - - -- - - - - - - - - -- - -- -- - -----------------------------------------------
C- nit_n1v of Albemarle Det)artment 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 com
Violations:
Y/N
If so, List:
Variance:
Y/N
If so, List:
the
Intake to complete the following:
Y (/ N'
Is bs n LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y
WIfRhirre 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 p l 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
Is
Is UFuo lic water and sewer?
Y /
Wi u be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit #
Y
Wi l_thef e be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Is/
Is t ' or sales of Fireworks?
If so, obtain a copy of F/R permit.
Permit #
Proffers:
Y/N
If so, List:
SP's:
Y/N
If so, List:
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