HomeMy WebLinkAboutCLE200500016 Action Letter 2017-07-31Albemarle County Department of Community Development
Application for
Zoning Clearance
Tax Map/Parcel:_ i< JXAJ
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m Parcel Owner: kAL�V-+-
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4 Address a6 5b -
r (Includh suite or floor)
Fee of $35.00
Check #
Recept # Nq
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City Lei 1Lli'lb�U� Elite Zip 99
Existing Zoning: Lb AA C,
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Who should we call/write concerning this project? 3- e.V if. Me l `T c r )
Address '_P.Q • enJ L 'R1 q-1 City ChRHM--ksu i Wte Zip � 7 U (P
Office Phone: (5I _1 Q - � 1 �_9 I Cell:
Fax: LC-1 G — 35 4 0 _ _ E-mail:
Business Namet7ype:
U I l IP-, VCxI r-1
Previous Business on this site: LCNn -� Ja -J v _
Proposed use:
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 kxation, a new Zoning
Clearance will be required.
I hereby certify that I own or have the owreis 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. I have read the conditions of approval, and I understand them, and that I will abide by them,
Signature r '�u�L Printed L-(r%k0L,4-S
•..................................................................... .. .........................................................
( ) Approved as proposed { Approved with conditions
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Building OfJ
Zoning Offs
481 Date A�4zv=
Date
Applicant to complete the following:
CY)/ 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 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 1 N Is use in LI, 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.
f�� Zoning review can not begin until we receive approval from Health Dept.
Y .[ iV J Is parcel on private well and septic? If so, give applicant a Health Department form.
is Zoning review can not begin until we receive approval from Health Dept.
0 N Is on public water and sewer?
Y jl N) Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit #
Y 1 N Will there be any new construction or renovations? If so; obtain the proper Permit.
ZA
Permit #
Y 1 N Is this for sales of Fireworks? If so, obtain a copy of FIR permit.
Permit #
Zoning Tech to complete the following:
Violations: Y If so, List:
Proffers: Y If so, List:
Variance: Y 1 If so, List:
SP's YI�N If so, List:
Reviewer to complete the following: Square footage of Use:
01 N Permitted as j " .egcak Under Section:
Supplem�fitar�is�ldei:
Parkf 1 -. ; �. Required spaces: 17—
S S
Y 1 N Items to be v rified in the field: f j
Inspector Name & Date: