HomeMy WebLinkAboutCLE200500022 Action Letter 2017-07-31Albemarle County Department of Community Development
Fee of $35.00 File A C 11
Application for Check # Date:
Zoning Clearance 'ecept# 1 Staff.
Tax Map/Parcel: p_ ...
Parcel Owner:
Address City
Inc ude suite or floor
Who shoe
Address
State I / Zip
Existing Zoning:
Office Phone:V5� Cell:
Fax: �� E-mail:n�-�-
c Business Name/Type: V
Previous Business on this site: __ _
o �.
.S Proposed use: .. /� � � s _ lin2 ?n[a
m
4
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 owners 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 k edge. I have read the conditions of approval, and I understand them, and that I will abide by them,
Sig naCre i Printed /I
proved as proposed- -�����-"--"(' � Approved with conaitions-------'""-"'-'-"'.--"-"
Building Official
Zoning Official �`..
Date
Date Z H 0—S"
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;
&l 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 I0 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 49 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.
�1 N Is on public water and sewer?
Y I(!)
N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit #
Y� N Will there be any new construction or renovations? If so; obtain the proper Permit.
Permit # W 7$ h 0-
Y 1 NO Its this for sales of Fireworks? If so, obtain a copy of FIR permit.
Permit #
Zoning Tech to complete the following: 0)
Violations: Y rN,1 If so, List: t L6C�
Proffers: Y I N If so, List:
Variance: Y / N If so, List:
SP's 1 N If so, List:
Reviewer to complete the following:
1 N Permitted as:
Supplementary regulations section:
41,
Square footage of Use:
4-0-_ Under Section: "Z 2 . 2. 1 (b 1
Parking formula: j sh.�. o,,,?cp tO ,, Required spaces: to
ZOC�? = 2eo
Y I V Items to be verified in the field:
Inspector Name & Date: