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HomeMy WebLinkAboutCLE200500055 Action Letter 2017-08-01 (2)Albemarle County Department of Community Development Application for Zoning Clearance Tax Map/Parcel: o Parcel Owner: �v a o Address (Inchide suite or floor) Fee of $35.00 Check # G Recept # State Zip Existing Zoning: 0, .._.....-•-----••-•-•--•...................••--------•-•----•-------•------•---•••--------•----------•----------•-------------- 6•-•- � -) y Who should we call/write concerning this project? ro Address � C Su' i©j r,i State Zip Jai/ Office Phone: -w"1 �f' L� Cell: Fax:( ')Ivy E-mail: ..------•---••---•...............•----------.......------•----•......----•--•--•-----•-•••-•-------•--....----..........---....--••-- o Business Name/Type: Previous Business on this site: e ' Proposed use: 1 a 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 know) I have read the con ' ons of approval, and I understand them, and that I will abide by them. Signatu Printed �/l /) ! / / (rA --•----•-- -----------------------.... --------------------------------............... ......... ...... Approved with conditions ................................ (j Approved as proposed ( ) 0 ._ 1.02 aBuilding Official SZ4� Date a^ Zoning Official 6`.4-J-1" U `Jlr�_ Date 2 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; CY)/ 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. hntakke�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 /o 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 t N) Is parcel on private well and septic? If so, give applicant a Health Department form. `1 Zoning review can not begin until we receive approval from Health Dept. ( Y)/ N Is on public water and sewer? Y ON Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # 6) N Will there be any new construction or renovations? If so; obtain the proper Permit. j� Permit # �9'iLi- ` 3 P 1. Y /I N 1 Is this for sales of Fireworks? If so, obtain a copy of F/R permit. �J Permit # Zoning Tech to complete the following: Violations: Y If so, List: Proffers: Y / N If so, List; Variance: / N If so, List: SP's Y / N If so, List: Reviewer to complete the following: C/ N Permitted as: Supplementary regulations section: Parking formula: I�f3 Y / Items to be verified in the field: Inspector Name & Date: Square footage of Use: Under Section: 2 2- 2, 1 I uired spaces: �r*h- Y.%_ 21tGPS k._— -