HomeMy WebLinkAboutCLE200500003 Action Letter 2017-07-31Albemarle County Department of Community Development
Application for
Zoning Clearance
Fee of $35.00
Check # ) bc) s
Recept # % -7 4 0
Tax Map/Parcel: d 69 10 0 00 CiO ` 1 06
m Parcel Owner:
4 Address
(Include suite or floor)
City
File #: CzDvs-- ex 3
Date: ) " S-DS-
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Existing Zoning: P D SC -
Who should we call/write concerning this project? 164 A-w e re
w Address l6Y 0 /6 City CA""'If «� State U� Zip Z -790 /
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4 Office Phone: Cell: 41311 $ 2-6 1 g'2'/
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Fax: S%3 4l Ty s'& -7-,5— E-mail: eer4aa,07 �6k & dcre, ezere
Business Name/Type: u�� r 4& 4i✓ S
Previous Business on this site: ,4aNi l c .��✓,.✓c S e*"el5 s /A14:;J
Proposed use:
Circle (if applicable): Fireworks / 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 cerUty that the information provided
is true and accurate to the best of my knowledge. I have read the condillons of approval, and I understand them, and that I will abide by them.
Signatur �• '-L' Printed crJWn/_'
------proiied-as proposed-[�-�-�------ ('Approved with conditions--------���----�---- --�
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4 Building Official Date I It -(,a
Zoning Official Date
Applicant to complete the following:
OY / N Do you have one of the following:
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
CY) 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.
iintake to complete the following:
Y /0 is use in LI, HI or PDIP zoning? if so, give applicant a Certified Engineer's Report (CER) packet.
j 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 CN 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.
V/ N Is on public water and sewer?
Y Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit #
Y I(S) 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 FIR permit.
Permit #
Zoning Tech to complete the following: G�'pjp�(.� 1 0 �� ]�- `�
Violations: Y / N If so, List:
Proffers: Y N If so, List:
Variance: Y / If so, List:
SP's Y 1 N If so, List:
Reviewer to complete the following:
�Y N Permitted as:
Supplementary regulations section:
Parking formula. r` C�
Y items to be verified in the field:
Inspector Name & Date:
Square footage of Use:
Under Section:
uired
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