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HomeMy WebLinkAboutCLE200500035 Action Letter 2017-07-31Albemarle County Department of Community Development Fee of $35.00 File #: C Z 00 S- 0.3 Application for Check# ODate: /os— Zoning Clearance Recept# 78op/ staff: Tax Map/Parcel: - 0 7R)p 00 d2 0-3 Go Parcel Owner: _ pC T _r V f "? G . Address (include suite or floor) City State Zip Existing Zoning: FID + C_ Who should we call/write concerning this project? 1--ej e fit: tl C &Sr\ e (t c c Address 600 Pedtf fd,Fm _ City C_-J%r t tLr_ State Zip Z2.51-0 _ 4 Office Phone: D • Se�{e.���'l Cell: OY3 Y - 70. - y Q Fax: E-mail: -----------------•-•--------------------------•-•-•---------------------------------------------------------------------------------- c Business Namerrype: 7;:VK(:Cr_s 0 V 1 d 2" G� 0 (Ke?f ; 4 to Previous Business on this site: Ca rg-\r'J c1 Proposed use: O � Cr:Q 01CICLG at �o 4 Circle (if applicable): Fireworks 1 Christmas Tree `This Clearance will only be valid on the parcel for which it is approved. It you change, intensify or move the use to a new location, a new Zoning Clearance will be required. I hereby certify that 1 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 edge. I have read the conditions of approval, and I understand them, and that I will abide by them. Si Mature Printed+ .............................................. 40......•---•--...------•-----.....---------- } Approved as proposed ( ) Approved with conditions a ro aBuilding Official Date Q Zoning Official Date o 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. ntake to complete the following: ,(16 is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. 16 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 6 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. 0 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 # N Will there be any new construction or renovations? If so; obtain the proper Permit. Permit # O OS'A L- 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 if so, List: Proffers: Y 1 N If so, List: Variance: Y 1 N If so, List: SP's Y 1 N If so, List: Reviewer to complete the following: Square footage of Use: Y/N e1N Permitted .1 ` Under Section: ZSA _2, Supplementary regulations section: W4Qq..a :2-oQ Items to be verified in the field: Inspector Name & Date: