HomeMy WebLinkAboutCLE200500009 Action Letter 2017-07-31Albemarle County Department of Community Development
Fee of CJ $35.00 Filet 0��
Application for Check # _b 3() Date: 1 [[
Zoning Clearance "espy 07 Staff.
Tax Map/Parcel: U Vm
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roParcel Owner: p1j, 'A6 ykgo
CT '0 d&4zp1Address State
(Include suite or floor) 1
Existing Zoning: /
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ho should we call/write concerning this project? A(he-11o, Ninny
Address 102- -V- _v}/ Avg City ' nZ State VA Zip 7_q7
a o Office Phone: ���- (137U Cell: o6yq
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Fax: E-mail: M I N D k oT W V CLA Q D. [ O rye
Business Name/Type: Ovlra_nt C�ll.LtYGs�. (4Q
Previous Business on this site:
Proposed use: I-v tub k
Circle (if applicable): Fireworks / Christmas Tree S—
'This Clearance will only be valid on the parcel for which It Is approved. If you change, intensity or move the use to a new location, a new Zoning
Clearance will be required.
I hereby eerdly that l 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. J have read the conditions of approval, and I understand them, and that twill abide by them.
Signature / `�` — '/�_ Printed Af I c he f )e-
............................................................................:....................................
( roved a proposed ( ) Approved with conditions
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aBuilding Official Date
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Zoning Official 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 PV 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 1 N Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet.
1 d� 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.
{ 1t9 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.
9 N is on public water and sewer?
Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit #
y /OWill there be any new construction or renovations? If so; obtain the proper Permit.
r' le�'� Permit #
Is this for sales of Fireworks? If so, obtain a copy of FIR permit.
Permit #
Zoning Tech to complete the following:
Violations: Y 1 N If so, List:
Proffers: Y 1 if so, List:
Variance: Y 1 If so, List:
SP's Y If so, List:
2eviewer to complete the following:
9 / N Permitted as: "
Supplementary regulations section:
Parkina formula: _-B- y...Jt- to
� 1 N Items to be verified in the field:
Inspector Name & Date:
Square footage of Use:
Under Section:
Required s aci