HomeMy WebLinkAboutCLE200500023 Action Letter 2017-07-31Albemarle County Department of Community Development
Application for
Zoning Clearance
Tax Map/Parcel:
Fee of $35.00
Check # 1 7 6
Recept # 7 D
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R I e #: V r✓L'00 —Ina 3
Date:
Staff:
� � Parcel Owner: t- oa,
aIt-T1 Address m,, N b+Ch� City C' State _Vk.zip _ r
(Include suite or floor)
W U , Existing Zoning: Cc N M:F_ la,4 -6" l
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Who should we call/write concerning this project? GO—e, y -�-U 2;--,
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Address City (i,jel�;r_:CState Zip ;41 �k9 a 7 y
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a Office Phone: 4' �` a3-"�s��� Cell: 74)
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Pax: E-mail:
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c Business Name/Type: 1\A1 O'kk-r r
Previous Business on this site: _ SCh O 1
Proposed use:
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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.
1 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 knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signatur Printed � } l [ kin -
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( )Approved as proposed with conditions
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Building Official Date ZJ
Zoning Official Date 1
kpplicant to complete the following:
( I N Do you have one of the following:
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
(1 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.
ntake to complete the following:
►' 1 �I is use in.Li, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet.
( 1 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.
1 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?
N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit # j
f 1 N Will there be any new construction or renovations? If so; obtain the proper Permit.
Permit #
(/0 Is this for sales of Fireworks? If so, obtain a copy of F/R permit.
Permit #
Zoning Tech to complete the following:
Violations: Y 1 N If so, List:
Proffers: Y ! If so, list:
Variance: If so, List:
SP's Y N If so, List:
2eviewer to complete the following:
Square footage of Use:
DN Permitted as: Qn ,� Under Section: 5V zoo,4
Supplementary regulations section:
.Parkingfarking formula: Required spaces:
N Items to be verified in the field: EZ r <ci
J Inspector Name & Date: