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HomeMy WebLinkAboutCLE200500042 Action Letter 2017-07-31Albemarle County Department of Community Development
Fee of $35.00 File#: 4)
Application for Check# 1 DI Dale:
Zoning Clearance ReceAt# Staff:
Tax Map/Parcel: - a 7 OD — oo-- o ^^-
e �I
«Parcel Owner: C�JnR,..
�,..
� ro a 0' Address City 1 Ck(Nha . State zip Z3
(Include suite or floor)
kbo+ -&k_A-m f )L& ._ SIC 3W Existing Zoning: P DM C--J
Who should we call/write concerning this X an
project?ram � ZJ
Address ,Cfin �` f �a State � Zip Z701 r
Office Phone: �4-a4}_;�—ago O Cell:
Business Namerrype: We&K -{-h
Previous Business on this site:
Proposed use:
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 : squired.
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 W of my knowledge. I have read the conditions of approval, and I understand them, and that I MU abide by them.
Signature
Printed cg, � c--- ]' XM-N _1/'
.......... {................... ....................................................................
} Approved as propos ( Approveq with conditions
A0
qBuilding Official Date
Q'Kif Zoning Official Date
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, I 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 V) is use in LI, Hi or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet.
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.
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.
9/ N Is on public water and sewer?
Y 1 N9 Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit #
Y 1 CON Will there be any new construction or renovations? If so; obtain the proper Permit.
J� Permit #
Y 1(N } Is this for sales of Fireworks? If so, obtain a copy of F/R permit.
v Permit #
Zoning Tech to complete the following:
Violations: Y 1 N If so, List:
Proffers: Y 1 If so, List:
Variance: Y 1 If so, List:
SP's Y / N If so, List:
1eviewer to complete the following:
Square footage of Use:
1
Y 1 N Permitted as: ,ru ; .d Under Section: 25 [4 2 • 22.z. rbi +
1
Supplementary regulations section:
formula:
� Sd i, Required spaces:
1513 K 361. = n,66 -izas
Y 1' Items to be verified in the field: r�.., ►ice i%wGCG �.,, a
Inspector Name & Date: