HomeMy WebLinkAboutCLE200500030 Action Letter 2017-07-31Albemarle County Department of Community Development
Application for
Zoning Clearance
Tax Map/Parcel:
Fee off $35. 00
Check # n/ 0 /
Recept # / 0 ()
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Parcel Owner: ���''� it
lk o Address City
JS (Include suite or floor)
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Existing Zoning:
File #: 6 24� 51 63
Date: Q se-
staff:
State Zip
T2pM C�,
Who should we call/write�concerning this project?
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c Address � e-�'lr�E'f p+Ywy City State Zip
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4 Office Phone: Cell:
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Fax: E-mail:
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c Business Name/Type: Q0'c l04-�' a 5 J. �� e ,� C� GZ ry et 0
"' Previous Business on this site: t') 0-'k1 Cbl.db VI)Oe 4
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Proposed use: _r a�.. c..-ac a
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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 o owledge. I have read the conditions of approval, and
II understand them, and that I/will abide by them.
Signature Print d
...._. (proved as proposed------�................•...( Approved with conditions .................+.............
Building Official
Zoning Official
Date 31 t l
Date 2 2�
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;
Y / 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 IDY Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet.
f 1611 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.
f 1 6t 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.
1 N Is on public water and sewer?
Y / Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit #
f 1 N Will there be any new constructs or renovations? If so; obtain the proper Permit.
Permit # t O ORIP)hAA C, I
f /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 / N If so, List:
Proffers: Y / N If so, List:
Variance: Y / N If so, List:
SP's Y / N If so, List:
2eviewer to complete the following:
0/ N Permitted as:
Supplementary regulations section:
Square footage of Use:
Under Section: 3 .2"
a; _!`lE9 x sr0i Required spaces: I7 S'O—o-Z
f 0 Items to be verified in the field:
Inspector Name & Date: