HomeMy WebLinkAboutCLE200500064 Action Letter 2017-08-01Albemarle County Department of Community Development
Application for
Zoning Cle
Tax Map/Parcel:
Fee of $35,00
Check #
Recept #
File #:
-_ ,Q
Date:
staff:�.(
Parcel Owner: _
Address kz1S QNm City �����. �� State Zip
5 (Include suite or floor)
Who should we call/write concerning this project?
Address k,-31.3 (Ar,,\N
Existing Zoning:
L-IL
City State�A Zip
Office Phone: �� - ��g Cell: a Ll _Q1)en
Fax: W -. 3 S � E-mail: 71 'X C:31 \ • U ,
c Business Name[Type:
a
to Previous Business on this site:
Proposed use:
m
a
Circle (if applicable): Fireworks 1 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.
1 hereby certify NMI 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 the best of knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed �Q_r Y4L
--------(... }Approved as propos11 ed........................ .. ( -) Approved with conditions ...----.......................
Building Official
Zoning Official
Date
Date 7 v�
Applicant to complete the following:
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 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:
I N Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet.
VY /I N Will there be food preparation? If so, gave applicant a Health Department form.
Zoning review can not begin until we receive approval from Health Dept.
Y ON 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?
�_J / N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit # _6�
Y Will there be any new construction or renovations? I# so; obtain the proper Permit.
Permit #
Y A N J Is this for sales of Fireworks? If so, obtain a copy of FIR permit.
v Permit #
Zoning Tech to complete the following:
Violations: Y / N If so, List:
Proffers: Y 1 N If so, List:
Variance: Y / N If so, List:
SP's Y / N If so, List: _
Reviewer to complete the following:
01 N
Permitted as:
Supplementary regulations section:
Parkina formula: Gh^']^� to
Square footage of Use:
Under Section: 2,?, 2
Reauired spaces:
Y 1(�) Items to be verified In the field: L C r
Inspector Name & Date: