HomeMy WebLinkAboutCLE200500053 Action Letter 2017-08-01Albemarle County Department of Community Development
Fee of $35.00 File #:
Application for Checl<# 7 13 Date:,
Zoning Clearance Rece,l *D J19Staff:
Tax Map/Parcel CPM-� -
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Parcel Owner: eS
a ,o I AddressAlb City ` Ilk State �f�Zip ; :;a,c' k � (In a sui a or floor) '
Existing Zoning: 21) AA 0.
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Who should we call/write concerning this project? S�r_M,P_
c .o Address .( , L014-'S l q`7 City 0,t)1 t' laj U i i bRate �) A� Zip P
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ao Office Phone: Cell:
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Fax: LP— 55 10 E-mail:
Business Name/
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Previous Busine:
42
Proposed use:
1
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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 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 knowledge. I have read the conditions of approval, and I understands them, and that I will abide by them.
Signature �. L,jrL,� Printed l ft r- 1_ l /ll - nus
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Approved �R -1 ---------------------...----...--------•-----------....
( ) H roved with conditions
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Building Offal
Zoning Offici
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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 / 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 / N 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.
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.
Y N Is on public water and sewer?
Y / N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit #
cy;/ N Will there be any new construction or renovations? If so; obtain the proper Permit.
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Permit # I W
Y / N Is this for sales of Fireworks? If so, obtain a copy of F/R permit.
Permit #
Zoning Tech to complete the following:
Violations: A�N
If so, List:
Proffers: If so, List:
Variance: If so, List:
SP's If so, List:
Reviewer to complete the following:
Y / N Permitted as:
Supplementary regulations section:
Square footage of Use:
Under Section: Z S , Z
i Reauired spaces: 12
Y /® Items to be verified in the field:
Inspector Name & Date:
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