HomeMy WebLinkAboutCLE200500024 Action Letter 2017-07-31Albemarle County Department of Community Development
Fee of $35 oQ File t
Application for Check # 321fo Date:
Zoning Clearance Rece'# 2.5 Sta
Tax Map/Parcel:
Parcel Owner:
Address
suite or floor)
City `w State Zip O%U�
Existing Zoning: W.
Who should we callAvrite conceminae&
g this project? • rr
w Address Iq1 �. S4VJWrfi , 'of City 117JA AkikkkState VOL Zip �n/
y m �.J.�p � ,r-� 7
a � Office Phone: �J3 4 Cell: "" qAq-'&]
Fax: E-mail: C�17'
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c Business Name/Type: �s
r�ro Previous Business on this site:
Proposed use: '
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a
Circle (if applicable): Fireworks / Christmas Tree
'This Clearance wN only be valid on the parcel for which It is approved. If you change, intensify or move the use to a new location, a now 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 knowledge, have read theSons o�fja�ppp I, and I understand them, and that I will abide by them.
Signatu !Vrinte
.......{ .. ) Approved -- proposed- ----------------------- -- --- Approved wi#h conditions .....----------.....-----------
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Building Official
Zoning Official
Date 11 �+ a
Date
Applicant to complete the following:
vl 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 �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 / Is use in Ll, HI or PDIP zoning? if so, give applicant a Certified Engineer's Report (CER) packet.
y 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.
u Zoning review can not begin until we receive approval from Health Dept.
t: f N is on public water and sewer?
Y 1 N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit# �- b ft�n
Il-.for � �'
Y 1 N Will there be any new constructimorVooaations? If so; ob m the proper Permit.
� Permit # �� PIC
Y A N 1 is this for sales of Fireworks? If so, obtain a copy of F/R permit.
Permit #
Zoning Tech to complete the following:
Violations: Y If so, List:
Proffers: Y 1 If so, List:
Variance: Y / If so, List:
SP's Y 1 If so, List:
Reviewer to complete the following:
Y 1 N Permitted as:
Suplerg�ntary regulattong
�: aAN.k,
Y 1 N Items to be verified in the field:
Inspector Name & Date:
Square footage of Use:
Under Section:
a 7& 11-