HomeMy WebLinkAboutCLE200500054 Action Letter 2017-08-01Albemarle County Department of Community Development
Fee of $35.00 Filet
Application for Check# Date: ff
Zoning Clearance Recept# Staff:
Tax Map/Parcel: &5366 -019 - X -6 3 4/ E-0
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mParcel Owner: J fie. N`w
a � Address VTq Ty ,,,., City
5 (Inclu a suite or floor)
State U,+ ' Zip 2 LQp
Existing Zoning: _ 0 J
Who should we call/write concerning this project? N rc"Lf') A
Address 4 jaw%�L—LYIA�jCity StateVA. Zip _ Z a AY43
1 Office Phone: 4� 4 — �7 v Cell: $ 2,S•�$p�
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Fax: 434 — 8 / 7 — 4a T o E-mail: 1'—z&W&
c Business Namerrype: N L7*-,r)+ J7`f�2_ -�s $ _
Previous Business on this site: Xt � �r. ,_,-,�.•
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Proposed use: Adw l %-; j� t,'
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Circle (if applicable): Fireworks / Christmas Tree
'This Clearance will only be valid on the parcel far 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 understand them, and that I will abide by them.
Signature Printed P1 4 G e
......................•-----------..........._..._................------• ................................. }Approved as proposed ( ppraved with conditions
Building Offit
Zoning Offci
Date c j
Date -21wlo
Applicant to complete the following:
1�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 / N Do you have a Floor Plan (sketch or an architectural drawing) that includes the following: 2
The total square footage of the use and/or;
The square footage of each room or area of use; If
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 N Is use in Ll. 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.
Y / lJ 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.
Dy / N Is on public water and sewer?
Y 16
Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit #
Will there be any new construction or renovations? If so; obtain the proper Permit.
Permit #
Y 1 Is this for sales of Fireworks? If so, obtain a copy of F/R permit.
Permit #
Zoning Tech to complete the following:
Violations:
Y 1 N
if so, List:
Proffers:
Y / N
if so, List:
Variance:
Y / N
If so, List:
7VUrX-6
SP's Y D If so, List:
Reviewer to complete the following: Square footage of Use:
YP/ N Permitted as: V Under Section: ZZ2 1•
Supplementary regulations section:
Parking formula: xr ?&C- t, 'f4 74 Required spaces: s
Y / N Items to be verified in the field:
Inspector Name & Date: