HomeMy WebLinkAboutCLE200500025 Action Letter 2017-07-31Albemarle County Department of Community Development
Fee Of $35.00 File #:
Application for Check# /o)- q1 Date: S
Zoning Clearance Re�pt# S s�
g
Tax Map/Parcel: ()90 _ M -IT 0 d'�!lY
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Parcel Owner:
Address
(Include suite or floor)
City State Zip
Existing Zoning:
......................................................................................................................................
Who should we call/write concerning this project? 7 ��--
,oc Address Ili ,- yyJoaa (rj City kik4eviVe State VA- Zip /
a c Office Phone: Cell:
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Fax: oiy`-4-• (°' q6c' E-mail: 1.e.0 YLO 7,1' teD Yl&hmd.CoYrI
c Business Name/Type:
0
Previous Busine:
Proposed use:
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U
to
4
Circle (if applicable):
Fireworks / Christmas Tree
*This Clearance will only be valid on the parcel for which it Is approved. If you change, Intensity or move the use to a new location, a new Zoning
Clearance will be required.
I hereby certify that 1 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.
Signature 0Printed 61:5ev �q. SU.-)-
....----•....................... .. .............................................-----............------...................
! 1 Annrn�pri as n nsPd 1 _ AnnrnvPrf with rnnriitinns
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Building Official^
Zoning Official
Date -z o
Date
Applicant to complete the following:
Y N Do you have one of the following:
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
DY 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:
Y 1 N Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet.
Y v 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.
e ON-) 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.
D1 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 #
,(j(9 Will there be any new construction or renovations? If so; obtain the proper Permit.
Permit #
r' 10 Is this for sales of Fireworks? If so, obtain a copy of FIR permit.
Permit #
Loning Tech to complete the following:
Violations:
Y 1
Proffers:
Y 1
Variance:
Y 1
SP's
Y 1 N
If so, List:
If so, List:
If so, List:
If so, List:
2eviewer to complete the following:
_ N Permitted as:,,,,,,
Square footage of Use:
Under Section: Z q , Z, 6
Supplementary regulations section: -
Parking formula: 11111M Required s aces:
6-1@Items to be verified in the field: r
6
Inspector Name & Date: