HomeMy WebLinkAboutCLE200500029 Action Letter 2017-07-314 ,o
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Albemarle County Department of Community Development
Fee of Q5.00 Fie 00, -- QaR'
Application for 761 Date: os
Zoning Clearance Recepl# 7S8r Stagy. -�
Tax Map/Parcel: () - -OD 6v 00 63) Gb
Parcel Owner:
Address
(Include suite or floor)
City State I Zip
Existing Zoning:
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Who should we call/write concerning this project?
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Address 600 - � r
ity
State Zip
Office Phone:
Cell: Y 3 c/-
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Fax:
E-mail:
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Business Name/Type: DR, �), C-b(t_+ &\
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Previous Business on this site: Net,,
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Proposed use: � J o2d
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Circle (if applicable): Fireworks / 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 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 my knowledge. I have read the conditions of approval, and I understand them, and
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that I will abide by them.
Signature Printed rr �. c 4
-Approved as proposed ( Approved with conditions
Building Official
Zoning Official
Date 71,o ,r
Date Z 27
4pplicant to complete the following:
k
Y 1 N Do you have one of the following: #
Tax Map and Parcel Number and or;
1
Address of use (include unit or floor if appropriate;
Y / N Do you have a Floor Plan (sketch or an architectural drawing) that includes the following: i
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:
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet.
1. 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.
(/0 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.
I N Is on public water and sewer?
Y / V� Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit #
O1 N Will there be any new construction or renovations? If so; obtain the proper Permit.
Permit # )�05 , ac�-7 4-c—
{ 1 N) Is this for sales of Fireworks? If so, obtain a copy of F/R permit.
Permit #
Toning Tech to complete the following:
Violations:
Y ! N
Proffers:
Y I N
Variance:
Y 1 N
SP's
Y / N
If so, List:
If so, List:
If so, List:
If so, List:
Zeviewer to complete the following:
N Permitted as: .�
Supplementary regulations section:
Parking formula: t
{ 1 N items to be verified in the field:
Inspector Name & Date:
Square footage of Use:
Under Section:
Sic+ �-'Wx Required spaces: Its
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