HomeMy WebLinkAboutCLE200500013 Action Letter 2017-07-31Albemarle County Department of Community Development
Fee of $35.00 File #: -
Application for Check# Date: •-
Zoning Clearance Recept# Staff:
Tax Map/Parcel:
o �l � w Parcel Owner:
4 Address ]�1�,1 r City State zip
J (Include suite or floor)
Existing Zoning:
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WWho should we call/write concerning this project? �e' L 1`
c o Address ?j� ,/ City `t &L State VA- zip aa-(o 3 0
3_a M Office Phone: C �6.35 ��3 29
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Fax: 84o — (93 5 — qa3 0 E-mail: 1�+.x>:l .v(>��cinnln Ii7r�l nea0tn . C0tnn
0 Business Name!
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Previous Businei
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 IVbest of my knowledge. i have read the conditions of approval, and I understand them, and that I will abide by them.
-4SignatureAf_�TPrinted ��.(, f
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{ )Approved s proposed {�A'j Approved with conditi s r
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aBuilding Official �! Date oS
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Zoning Official Date ?-W
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; o �r KQ l_.er-Je✓
D1 N Do you have a Floor Plan (sketch or an architectural drawing) that includes the following:
The total squa a 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 I N is use in Ll, 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.
Zoning review can not begin until we receive approval from Health Dept.
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.
Is on public water and sewer?
Will you be putting up a new sign of any kind((? If so, obtain proper
Si n permit.
Permit # ' l�ii(� ► `�q� �Tl
new construction or renoirations? If so, Obtain the proper Permit.
Will there be any p p
Permit # _
Is this for sales of Fireworks?
Permit #
Zoning Tech to complete the following:
If so, obtain a copy of FIR permit.
Violations: Y N If so, List:
Proffers: Y N If so, List: , ZD n3'L In • 0�
Variance: Y N If so, List: -UTj ��j' ( , d�-
SP's Y fa If so, List:
,reviewer to complete the following:
DN Permitted as: J br t C1 rx�► `I
Supplementary regulations section:
Square footage of Use:
Under Section: 251Z• 1
.Parking formula: aSpa&per In SF oFC4s*Jr,, Required spaces: 'I5pALeS
t'�Gr�a-'�irn►a�. S $5�at ��, �6 S� �� P��j pw�s{ ar, : I s��}.
Y 119 Items to be verified in the field: c � 0
Inspector Name ,& Date: