HomeMy WebLinkAboutCLE200500059 Action Letter 2017-08-01Albemarle County Department of Community Development
Fee of S35.00
File #:
Application for
Check #
cats:
Zoning Clearance
Rem'#
Staff:
Tax Map/Parcel'
Parcel Owner:]Dti�eLlyd-AtIL�7`.
� to
4 ro
Address C+ .
City
N(Include
State Zip
suite orfloor)
Existing Zoning:
R
Who should we call/write concerning this project?
Address f;s'p �S� �fl
City
State
n J
Office Phone: (��4 � �� 2213,
Cell:
_Zip
Q`
Fax:
E-mail'
Business NamelType: �f9S-~�#�R`r,�)
Previous Business on this site: .
Proposed use: Rcs)r, ,
Circle (if applicable): Fireworks 1 Christmas Tree
'This Clearance wil only be valid on the parcel for which It Is approved. If you change. Intensify or move the use to anew location, anew Zoning
Gearance will be required.
I hereby certify that I own or have the owners permission to use the specs indicated on this application. I also certify that the Information provided
is true and aoarate to the best of my knowledge. I have read the conditions of approval, and I understand them. and that I will abide by them.
Signatur Printed &,A g) ZVV
....................................................................... .......... .........
-----..... ..............................
{ ) Approved as proposed ( Approved with conditions
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Date
Date L�' / .. D5
Applicant to complete the following:
DY�)) N Do you have one of the following:
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
Oy 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 1 N) Is use In LI, Hi or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet.
(31 N Will there be food preparation? If so, give applicant a Health Department foram.
Zoning review can not begin until we receive approval from Health Dept.
Y N j is parcel on private well and septic? If so, give applicant a Health Department form.
U Zoning review can not begin until we receive approval from Health Dept.
N is on public water and sewer?
(Y V N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit #
OY' N Will there be any new construction or renovations? If so; obtain the proper Permit.
Permit # A(2'
Y 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 1 N
If so, List:
Proffers:
Y 1P
If so, List:
Variance:
N
if so, List:
SP's
Y( �' N
If so, List:
Reviewer to complete the following:
Y
Square footage of Use:
Items to be verified in the field: `
Inspector Name & Date: