HomeMy WebLinkAboutCLE200500052 Action Letter 2017-07-31Albemarle County Department of Community Development
Application for
Zoning Clearance
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Tax Map/Parcel:
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Fee of $35.00
Check # S�
Recept # 0,7
7,D0
File #.
Date:
Staff:
C V V Iry I1 r
Parcel Owner:y
'No Address City Uri ' e State (Jct Zip2Z�S
(!nflueS41116 floor) ; D
Existing Zoning: c
Who should we call/write concerning this project? - AM N6--1YVCd
ro '.2 Address 21 1W-MW' City / State t,14_ Zip Z2LeZ
4 `o Office Phone:C.Cell: �r 3TZ
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Fax: E-mail:
Business Name/Type:
Previous Business on this site:
Proposed use: !f , c
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Circle (if applicable): Fireworks / 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 of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed / lq/kl / 4. f
........ -------------•---.........._....__ .................................-----•------.........---.....-----............---.....
( }Approved as proposed ()✓Approved with conditions
Building Official
Zoning Official
9 07 � W, R1 � Z wocK ro
Date -4
Date 07- L:2412bcC
Applicant to complete the following:
l� 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;
� 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 10 Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet.
Y, 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 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.
1 N Is on public water and sewer?
S 1 N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
e Permit #
f /`N Will there be any new construction or renovations? If so; obtain the proper Permit.
Permit #
f 1` N Is this for sales of Fireworks? If so, obtain a copy of FIR permit.
Permit #
Zoning Tech to complete the following:
Violations: Y N If so, List:
Proffers: Y N If so, List:
Variance: Y 1 N If so, List: nr-- � 9�Lj •5cl
SP's Y 1 N If so, List: Qj • 9 ?j
reviewer to complete the following: Square footage of Use:
N Permitted as: S Under Section:25•2*102-�22.Z:1-bCZ)
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Parkin f � R Vi�Required spaces: � K tAnj a aos ou,, J)
1 I� Items toa verified in W Imk 4
Inspector Name & Date: