HomeMy WebLinkAboutCLE200500020 Action Letter 2017-07-31Albemarle County Depi rtmer..t of Community Development
Application for
Zoning Clearance
Tax Map/Parcel:
Fee of S35-00
Check #
Recept #
File #:
Date: s
Staff:
to
Parcel owner: C7 R t- ► iJ 1, 7c5',r-
it ,g Address I qi 0 T n r}�r 1n d 6'oA DR City CflK(_zTfWtFState i%, Zip ZZ` C!
(Include suite or floor)
,S 0 i &C 202 * 202 Existing Zoning:
Who should we call/write concerning this project? _ 'l i P'yl, GE, _
M Address �5v6 i; ( 0 u ' I +2,8 City CA!PR1 m5rxotate V4 Zip ?2qo i
Office Phone: 4 h - Cell: ± 3 4 — '531 3 tD'71
1102
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Fax: (f34 —'11 9_ 2 2 2 2- E-mail:
Business Name/Type: III V1 i
Previous Business on this site: i
Proposed use:
Circle (if applicable): Fireworks / Christmas Tree
'This Clearance will only be valid on the parcel far whkh 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 the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
I _
Signature L 'y PrintedJN ST
.(.. } Approve+dd
.as propose..-.-. ..................... � Approved
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Building Official
Zoning Official
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Date
Date ji
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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 I 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 / N Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet.
Y Io 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 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.
OyN Is on public water and sewer?
�iy N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit #
Y 1 0 Will there be any new construction or renovations? If so, obtain the proper Permit.
Permit #
Y / Is this for sales of Fireworks? If so, obtain a copy of FIR permit.
Permit #
Zoning Tech to complete the following:
Violations: Y N If so, List:
Proffers: Y If so, List:
Variance: Y / N If so, List:
SP's % N If so, List: n , " ' 1 _
Reviewer to complete C
following: Square footage of Use:
0/ N
Permitted as: Under Section: • 4.&- �• �3
Supplementary regulations section:
Items to be verified in the field:
inspector Name & Date: