HomeMy WebLinkAboutCLE200500001 Action Letter 2017-07-31Albemarle County Department of Community Development
Fee of $35.00 File #: (� f
Application for Check# 11 Date:
Zoning Clearance Recept Stuff.
Tax Map/Parcel: alwo-ol "6)4 00,y
Parcel Owner:
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4 o Address City
(Include suite or floor)
State -ZIP
Existing Zoning: L-E—
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Who should we call/write concerning this project?
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c .0 Address 3�jIL� �/`��'� rd r�" �`�e City / tate Zip
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I Office Phone: ���� .,/ �Z Cell:
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Fax: 9-7 t 95///l E-mail: z,
Business Narne/Type:
`0 Previous Business on this site:
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Proposed use:
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Circle (if applicable): Fireworks 1 Christmas Tree
'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.
Signature Printed _
....................
.......................... ................................. ...r..._.._...-----------------................
( ) roved as proposed Approved with conditions
Building Official
Zoning Official
Date S �;
Date
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;
Y 1 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:
0(Y J N 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.
u . Zoning review can not begin until we receive approval from Health Dept.
Y /N 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?
N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit #
Y / Will there be any new construction or renovations? If so; obtain the proper Permit.
Permit #
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
/ N
If so, List:
Proffers:
Y N
If so, List:
Variance:
Y /
If so, List:
SP's
Y / N
If so, List:
Reviewer to complete the following:
CY)/ N Permitted as:
Y/N
Supplementary regulations section:
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Square footage of Use:
Under Section:
Parking formula: raAwlt RIO *TdA' .7j'.! . ` w= Z Require
$ ! P" ?_ /.— U"L...W_
Items to be verified in the field:
Inspector Name & Date:
Square footage of Use:
Under Section:
Parking formula: raAwlt RIO *TdA' .7j'.! . ` w= Z Require
$ ! P" ?_ /.— U"L...W_
Items to be verified in the field:
Inspector Name & Date: