HomeMy WebLinkAboutCLE200500021 Action Letter 2017-07-31Albemarle County Department of CommunAy DeveloP�ent
Fee of $35. 00 Flee #:
Application for Check# Date:
Zoning Clearance Recept# staff:
Tax MaplParcel:. t�>9 b 08 O C5 - DO (> ! -T i4
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Parcel Owner: V VV_b EN O MCM107-L BUILOIN§ U R o rD671 Cff L f- 5 s O C f} -L=5
4 a ; Address 165 Rl%A 7Lbyjl) D4. rl-JECIS -City C.*"_u7rr3vrWtate VA- Zip Z7-7 /1
(Include suite or floor)
Existing Zoning:
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Who should we call/write concerning this project? PEI: - 5
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Address
1 5 3 T)12AVF City C13'y ILLS State Az Zip 22ai 0
Office Phone: 4:54.47 0 - -79 6 j Cell: 43 4. q b S + b 2-3 5
Fax: y`3 4. 9'10 . 7 90 5-
E-mail: 'D9fPR a-FF-1'7 T ' (�D N -LDS . /VF —
Business NamelType: S L f r l I IG-&—i L---N0-{
Previous Business on this site:
Proposed use: i49YL- tE?5'T7"-'C— CL )5 /fv 6 S
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 nave 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.
signature �-� Printed CA9tA 7)' PJ` 61f117--
... (..) �C p►PProved-as proposed ons ........................... () A��roveppd with conditi----------..................._. p,CJt DtP.A&e q tJ CVk*f-
aBuilding Official Date
Zoning Official Date
Applicant to complete the following:
6)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,,Io 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 E
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet.
Y 1 Will there be food preparation? If so, give applicant a Health Department fora.
Zoning review can not begin until we receive approval from Health Dept.
Y (tv)
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.
0 N Is on public water and sewer?
Y /(�) Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit #
Y /PNWill there be any new construction or renovations? If so; obtain the proper Permit.
Permit #
Y ` N Is this for sales of Fireworks? If so, obtain a copy of F/R permit.
Permit #
Zoning Tech to complete the following:
Violations: Y
Proffers: Y
Variance: ° ' V
SP's Y
If so, List:
If so, List:
If so, List:
If so, List:
Reviewer to complete the following:
YJ N Permitted as:
Supplementary regulations section:
Parking formula: M?��
fox- l�o
YON Items to be v rifled in the field:
Inspector Name & Date:
Square footage of Use:
Under Section:
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