HomeMy WebLinkAboutCLE200500007 Action Letter 2017-07-31Albemarle County Department of Community Development
Fee of $35.0_0 Filet
Application for Check# t4S9 Cate: �-
Zoning Clearance Ste:
Tax Map/Parcel:
1 l:_ 1 �.r i •_ ..:�
C a , 4
IParcel Owner: 4
4 0' Address
(Include suite or floor)
City V State Zip
Existing Zoning: _ H OI
Who should we call/write concerning this pro'ect?
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Address �!'�.� City t�Zip
Office Phone: a�! S S�� . _ Cell: 2 4
Fax: �� r Ff� _� -- I E-mail:
Business NametType:
Previous Business on this site:
Proposed use:
Circle (if applicable): Fireworks 1 Christmas Tree
'This Clearance will only be valid on the parcel for which it is approved. tf 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 permisslon to use the space indicated on this application. I also certify that the information provided
is true and accurate to the best of my knowl ttions of approval, and I understand them. Jand that I will abide by them.
Signature Printed
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---.. +)Approved a. proposed....... ��- - -�-{ ) Approved�with,corlfitions - - - -�-�- --- -----
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Building Official Date t V-1
Zoning Official
Applicant to complete the following:
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N Do you have one of the following:
O—y
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:
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 N Is use in Li, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet.
Y I� 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.
® A 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.
a/ N Is on public water and sewer?
Y (N1 Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
�J Permit #
Y N Will there be any new construction or renovations? If so; obtain the proper Permit.
j Permit #
Y / N 1 Is this for sales of Fireworks? If so, obtain a copy of F/R permit.
�J Permit #
Zoning Tech to complete the following;
Violations: Y N If so, List:
Proffers: Y / QV If so, List:
Variance: O N If so, List:
SP's. Y ( N ) If so, List:
Reviewer to complete the following:
l.% / N Permitted as:
]U •/3
Square footage of Use:
rbh4 Under Section: A4. 2•
Supplementary regulations section:
Parking formula: SQq(,f„¢Gf2w SF ofT Required spaces:
�zx c. g, �osi•6/aoo - s• 4o g .,
Y items to be verified in the field: t A-9 6 S .
inspector Name & Date: