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HomeMy WebLinkAboutCLE200500028 Action Letter 2017-07-31Albemarle County Department of Community Development Fee_ of $35.00 File #: G Oi Do r Application for Check # ele r Date: 4 Zonin Clearance Recept# 7S8 sin: g Tax Map/Parcel: 0 ! 0 Q0 — �Z -- L93/ G d m a Parcel Owner: I��/Tr-i`f"�d' ILE L—c­ 0! ,e Address City State Zip (Include suite or floor) Existing Zoning: FD M C- Who should we call/write concerning this project? �ph: "� I�p.h� C., Address 60o � �.. �-r`.oPScJ� ity State Zip `aa Office Phone: Cell: 7 1` G 3 q- Q � Fax: E-mail: •-•.........................•-----......------........------------------..................---•------------------.........---•-----.... Business Name/Type: M 0 0 Previous Business on this site: t JO_ •1 Co r\5 4 le Proposed use. V t, • 4r.- C' 5f= w v G1 a Circle (if applicable): Fireworks / Christmas Tree 'This Clearance will only be valid on the panel 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 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 m knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature Printed c� R r►tir proposed- �....................... .................. (�praved with conditions ............................... le— Building Official Zoning Official Date J Date Z 2 Applicant to complete the following: Y 1 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 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. Intake to complete the following: Y 1 I Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y 1Will there be food preparation? If so, give applicant a Health Department form. 8 Zoning review can not begin until we receive approval from Health Dept. Y 1 NQ 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. 6)/ N Is on public water and sewer? Y 1 ® Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # U1 N Will there be any new construction or renovations? If so; obtain the proper Permit. Permit # dOO51- 89 V Ac Y ! I� Is this for sales of Fireworks? If so, obtain a copy of F/R permit. Permit # Zoning Tech to complete the following: Violations: Y / N If so, List: Proffers: Y 1 N If so, List: Variance: Y / N If so, List: SP's Y 1 N If so, List: Reviewer to complete the following: Square footage of Use: Ci N Permitted as: Under Section:25 19 `z Z3.IV 2. � Supplementary regulations sedo" n: .Parkindfwpula: Jsp rae,;►nA.-Oax$MO, Required spaces: l Y 1 Items to be verified in the field: L . L Inspector Name & Date: