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HomeMy WebLinkAboutCLE200500011 Action Letter 2017-07-31011071200,5 16:43 5619BB91382 WCTC PAGE 14115 IF./2003 12:30 CITIZENS STATE BANK 4 9061.99139992 'rbr�i2{Y1�111iC r�r t Q0 r416 D0e1 Albemarle County Dep rtment of G m uM oe+relopment � 7 ,Fee of File 9- oU. vS Application for ctmc# Zonis Clearance Re�s�� � �� Tat MelPM13=11; iDA -,°2 Paruel Owner. Y `�J l /kr L_�`t►�-�/5 Act- City OJA7 & tsr� [ State ip 0 7 -- �, ,� Address � (lndude suite ar floarj �� Exis#ing Zoning: .......r...................................•w..............w........_...................-.r....nw..w...............--ru.w...rr... Who should we call Its conceming this project? 1 WL I T�i�Ef l Torn!; ' 03 Address rj1��I,U�ISYt l6 City i tote AZIP — .-0=.z m a q. o Oiiice Fhane: w� co Cell: 4�� SI :"I `t"q( `�� f Fox, �✓ �.���Ca E-rnail: S �.�-►�T�ltc��� a nd— w ... ....... .....w.................... ...r.r u.w .......... ........ ......- .......-.. ......... .---..wwww. .....e .------- Business Narre/TYPe: Frevbus Bushn04 Proposed use; Circle ("# applicable): Fireworks ! Christmas Tr" ,TM awmj pa wM only be Vgrld on m pane fdr whteh It is pppmwd. if you ahmva, intefnsl"fy or mgws on uae to anew lacelion, a row Zoning Cleamnw�nll tw req-64 I hareny cardh+ihal I axn ur bevA ins owners Dermtssion W Usa dM � Indleaied on uas apPi;catlorL i el90 cer>rfy�l tl19 Ir?fbrrnst�on prn+�iQdQ true a g}e tT+l� bastof my kw"Mob. I how mid @ts condimm of Eppm a6 aad I uaderstdfld ban. smd that I WO eblds by them. 8ignatufe_ '•,� a� _ Printed 0 • M L O +`I'd S .aa ro. reed "------�................ Approved with odridjEions ..ww------------------•. Building Officlal Dt" Zoning Official oats. 01/07/2005 16:43 5619889882 WGTC 0if??r�605 12:30 CITIZENS STATE BANK 3 91561961391382 PAGE 15/15 NO,G16 1;902 Applicant to complete the follovrring' N E)o yoU have one of the following: TaX Map and Parcel Dumber Wd or; Address of use (include unft or floor If appropriate; ! N Do you have a Morn Plan (sketch or an architectural drawing) that includes the fallowing: The total square footage of the use and/or, The square footage Of each roam or Brea of Use; tlsa of each room or area If using less then the entire stilictura, note the location within the structure. intake to completo tns following; 0 N is use in LI, HI or PDiP xoning? if ea, give appiicant a Certified Engineees {deport (CER) psCket. Y I i% WIII there be food preparation? If sti, glue applicant a Haallh DeWtment form. Zoning review can not begin until we receive approve) from Health Dept. Y 1 N Is parcel on private waif and septic? ff so, give applicant a Health Department form - Zoning review can not begin until we rawNe approval' from Health Dept. •�`" U v I N Is on public water and sewer? Y 1 N Will you be putting up 8 new sign of any kind? if so, obtain proper Sign permit. Permit # (9! IV WIII there be any new oonstruobon_ _�_ or enovetlans? If sa, obtain the proper Permit. Permit # Y !� 1s this for sales of Firewor ? If so, obtain a copy of FIR permit. Permit # Zoning Tech to complete the following: VidaklonB: Y I If so, List Proffem: Y 1 if so, List: Varlance: Y I If so, list: SP's Y I N if so, List: Reviewer to Comiplete the followring: Square footage of Use: lJ' N Permitted as: }��S m 6 i under section. 7�� i3 �� 2 712.1-1 Supplementaryfegulations section; Perking formula: Required9 a g= .. �N Iterns to be verified in the field: -- Inspector Name & Dante: