HomeMy WebLinkAboutCLE200500050 Action Letter 2017-07-31Albemarle County Department of Community Development
Fee of, 3L&00 Filet �M_bW
Application for Check# D2te:
Zoning Clearance Recept# Staff
Tax Map/Parcel:
c
Parcel Owner:
Address
1 �
State Zip
Existing Zoning:
------------------------------------------------------------•----.._....------------------------•-----------.-................-----•-
Who should we calllwrite concerning this project?toj„a�,�{ 5a �• ,o rim_
t:
ro g Address 3 c,rn4,n� �� k- yn.► City (tlnkyto 1;(c9 ►t� State �_ Zip � 2 (7 5
A to
aE Office Phone:
Fax:
E-mail:5c v
Business NametType: V . I TISj} C_\
Previous Business on this site: It!11 A.) i f)rs
Proposed use: C r { 'e--'
Circle (if applicable): Fireworks 1 Christmas Tree
'Thle 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, 1 also certify that the information provided
is true and accurate to the best of my knowledge. I have read the conditions of approval, and I understand them, and that t Will abide by them.
Signature � � Printed 5le - .
WF6;;W's—�V
as roposed ..................•-------{ -) Approved with conditions ..............................
cutreint N
°A. •
a Building Official 4 Alc&&
J
Zoning Official �. _ _�� Date 4/0S
Applicant to complete the following:
(RV 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 V N Do you have a Floor Plan (sketch or an architectural drawing) that includes the following:
u 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 1a Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet.
Y 18 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 Is parcel on private well and septic? If so, give applicant a Health Department form.
13 Zoning review can not begin until we receive approval from Health Dept.
N Is on public water and sewer?
Y A jN Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit #
Y UN Will there be any new construction or renovations? If so; obtain the proper Permit.
Permit #
Y k NJ Is this for sales of Fireworks? If so, obtain a copy of FIR permit.
Permit #
Zoning Tech to complete the following:
Violations. Y If so, List:
Proffers: Y If so, List:
Variance: N If so, List:
SP`s Y 1 N If so, List:
Reviewer to complete the following:
01 N Permitted as:
Supplementary I
Items to
V
Inspector Nail
Square footage of Use:
J I
section: .
Section: 22 Z. , (