HomeMy WebLinkAboutCLE200500065 Action Letter 2017-08-01Albemarle County Department of Community Development
Fee of $35.00 File #: �glq 6—f
Application for checkDate.
Zoning Clearance Recept# Staff
Tax Map/Parcel: Q(! . 100--i o-- en �,l �d i� 0
c Parcel Owner: I I LC
,.pQ
4 0 Address Ci Zi
(include suite or Foor)
Existing Zoning: (�
Who should we call/write concerning this project?
o Address 100 G 14 S r Sr City G J a/ao State /L)C—Zip Z56 2
a Office Phone: B?n 9/ Z ?� Cell: 3-?i� p O /
S
Fax:
Business NametType:
Previous Business on this
Proposed use: (I s0 7p'e,N4�eo ow. a dhF- e!!5:7C/S 4?CtIe-al r.1 CG 1114 7-5Z ram`
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 tine information provided
is true and accurate the t of my kn . I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed 1�>, 6 \ �Ze±V 7-C 1Z
(-_ ) Approved_as proposed "_..___._'..............(Y pro►isd with conditions S "_��""`�__._._..
Building 01
Zoning Off
Backfiow Breadth
CWremTMI Dab
Date 3
Date ���
Applicant to complete the following:
�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:
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 is use in Li, Hi or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet.
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 I NJ 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.
0 / N is on public water and sewer?
61 N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit # 'Q 005_ WS
OYN Will there be any new construction or ren�o/vatiio/�ns??� If so; obtain the proper Permit.
Permit # O&OU I(V
Y /0, Is this for sales of Fireworks? If so, obtain a copy of FIR permit.
Permit #
Zoning Tech to complete the following:
Violations: JiN
If so, List:
Proffers: If so, List:
Variance:If so, List:
SP's If so, List:
Reviewer to complete the following:
1 N Permitted as; .Q
Supoe , vita regulations sectionp
� ry
fl N Items to be verified in the field:
Inspector Name & Date:
Square footage of Use:
Under Section: