HomeMy WebLinkAboutCLE200500034 Action Letter 2017-07-31Albemarle County Department of Community Development
Fee of $35 W File* C os-- 0 3
Application for go r Mts: y u-
Zoning Clearance Recept# IM( staff:
Tax Map/Parcel: /o a 0 0 031 (�::d ,
Zl
Parcel Owner: I " ���'` uG
Address I City
(include suite or floor)
Existing Zoning:
State Zip
P/4 p(::-
Who should we calllwrits concerning this project? iT4ti11L - n &_fJ !�' /"�L V
Address �N_3 iepr-' P)
Office Phone:
Fax:
City State Zip
Cell: 4 3 1F — -z' t 6- 6 'T 6 f
E-mail:
Business NamelType: G VJ 0 h D �J
Previous Business on this site: NCW Qt�IV.>AruAr-WN
Proposed use: H ed % cAl 1., -e
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 owner's pemrission to use the space Indicated on this application. I also certify that the information provided
is true and accurate to the best of y knowledge. I have read the conditions of approval, and I�undell
erstand them, and that I will abide by them.
Signature Print d C� r►
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... .............................................................................................................
proved as proposed ( Approved with conditions
a
a
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Building Official �! Date t [ of
Zoning Official Date 2 /2- /vS
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 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� 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.
Y / 61 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.
V I N Is on public water and sewer?
Y 1(5 Will you be putting up, anew sign of any kind? If so, obtain proper Sign permit.
Permit #
Y 1 N Will there be any new construction or renovations? If so; obtain the proper Permit.
Permit # 2,0 05 SJ 71
Y I O Is this for sales of Fireworks? If so, obtain a copy of FIR permit.
Permit #
Zoning Tech to complete the following:
Violations: Y 1 N
Proffers: Y 1 N
Variance: Y / N
If so, List:
If so, List:
If so, List:
SP's Y I N If so, List:
Reviewer to complete the following: Square footage of Use:
�1 N Permitted as: Under Section: 23. 2 , i (70
Supplementary regulations section:
Parking formula:" I aVC ' 2 ).Required spaces: 6'
Y I, N Items to be verified in the field: L G-
Inspector Name & Date: