HomeMy WebLinkAboutCLE200500017 Action Letter 2017-07-31Albemarle County Department of Community Development
Fee of $35.00 File #: —
Application for Check# wQC� Date:
Zoning Clearance Recept# staff:
Tax Map/Parcel: 0 �OQ —oc --oo — U 71900
aParcel Owner: i A jCL Cc yr„ ,7
4 Address tI� 5 �rK City Yi State Zip ZZ�Qo3
(Include suite or floor)
Existing Zoning:
Who should we call/write concerning this project? �10�I.1 6,C 7a 't ;
m Address ZS�S� J �} City L,>State Ua, Zip��5
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- � Office phone: q1 Z14A-- Cell:
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Fax: 4"34 4? . /O,r3,� E-mail: 6w OW7 Oa •C4 v-M
Business Name/
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Previous Busine:
Proposed use:
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Circle (if applicable): Fireworks / 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 bcation, a new Zoning
Clearance will be required.
I hereby certify that I own or have the owners permission to use the space indicated on this application. I also certify that the information provided
is true and accurate totheb of my kn ge. I hPave read the conditions of approval, and I understand tI, and that I will abide by them.
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Signature Printed 8��
�( -)Approved as proposed...... ...........
.-. iii.... ......Aroved wth conditions
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Date o '"
Date Y,6 AA
Applicant to complete the following:
Y 1 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 roam or area
If using less than the entire structure, note the location within the structure.
I
;Intake to complete the following:
Y ON
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.
Zoning review can not begin until we receive approval from Health Dept.
Y 1 N 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.
91 N Is on public water and sewer?
Y
Y 1 N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit #
Y C.N) � Will there be any new construction or renovations? if so; obtain the proper Permit.
Permit # _
Y / N 1 is this for sales of Fireworks? If so, obtain a copy of FIR permit.
�� Permit #
Zoning Tech to complete the following:
Vioiations: Y / N If so, List:
Proffers: Y 1 N If so, List:
Variance: Y / N if so, List:
SP's Y 1 N If so, List:
Reviewer to complete the following: Square footage of Use:
Y N Permitted as: Under Section: 22 2
VV
Supplementary regulations section:
Parking formula: j z&e N ¢' eRequired spaces:
279t 16'7T 5rk$C I, -,10$r - -2100
N Items to be verified in the field: tit:.. _.
Inspector Name & Date: 274 n
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