HomeMy WebLinkAboutCLE200500031 Action Letter 2017-07-31Albemarle County Department of Community Development
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Fe_ a of $35{{.00 File #: S`6 31
Application for Check# �]Q 1 Date:
Zoning Clearance Recept# - Staff:
Tax Map/Parcel: 6 % XOO 07l Q-U 031 G b
Parcel Owner: .Q n —4� C�
Address City
(Include suite or floor)
State Zip
Existing Zoning: PP/1 L'
Who should we call/write concerning this project? DO C Do W n ; nr, /17R • C��%S , s-�"ew�, ,-�
r ,R Addresse1H-erSDr, T �.i,,,a, City State Zip �z
4 0 Office PhorW Cell: * `43 S/ g i G r O% G 3
Q E
Fax:
Business Name/Type:
E-mail:
Previous Business on this site: Ne.W ccv+.,ACV �ralrl
Proposed use: PO C"; c' -\- ` h K( G
Circle (if applicable): Fireworks 1 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 owners permission to use the space indicated on this application. I also certify that the information provided
is true and accurate to the best qfmy knowledge. I have read the conditions of approval, and I�nderstand them, and that I will abide by them.
Signature Printed 1\,• ,ram (r
.......... ....................................•----.........-------..........................------•-----.........-........----•
pproved as proposed ( ) Approved with conditions
Building Official
Zoning Official �L#7�
Date %
Date 3
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 / 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:
{ 1® Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet.
{ I�l 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.
r ! Q 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.
01 N Is on public water and sewer?
f 16 Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit #
01 N Will there be any new construction or renovations? If so; obtain the proper Permit.
f� Permit # )-mS -Lir/70
r 1LN� Is this for sales of Fireworks? If so, obtain a copy of FIR permit.
Permit #
Coning Tech to complete the following:
Violations: Y I N
Proffers: Y 1 N
Variance: Y 1 N
SP's YIN
If so, List:
If so, List:
If so, List:
If so. List:
Reviewer to complete the following:
Square footage of Use:
N Permitted as: Under Section: 25P •2 •�3 •�•
Supplementary regulations section:
Parkino formula: ���- �,�2dnsFe _32-� Required spaces:
( 1� Items to be verified in the field:
Inspector Name & Date:
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