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HomeMy WebLinkAboutCLE200500067 Action Letter 2017-08-01'2005 09:28 FAX 434 972 4126 BLD COD$ & ZONING 1uu1 N 0- Albemarle County Department of Community Development k � a� -7 Feb of S35.00 File o- 2Do5-o� Application for Check* _5syo Date: 3 Q-fi Zoning Clearance Rece" - stagy Tax Map/Parcel., 0 (e / BO DI� �+ r Parcel Owner. I0 L- a 12 Address "�16 kho oia Y/t 0r e City CiAA y1a Hfsd�/e State L/A Tp `z-z''C-)l {include suite or floor Existing Zoning: , � 1} S 11 Who should we call/write concerning this project? kK 6,±f 4 W� M V M L- Sk-Address (030 �e WCram..--,� tYc�hayfvflPsu�`(( State Zip ?_z9{/ Office Phone: -1- Z — L5- o Cell: Fax: 3 q — 7,U, ­734)— E-mail: _eMMRA. w H7+.gY f, M-1H.are- o Business Name/Type: (b•P ma r be S e !~ '+A Ir@ '0 Previous Business on this site: ti ti Proposed use: _ ICI �•) rY.0- re L t;; ICE u m 0 a Circle (if applicable): ,This Clearance wiii only to vaj!d on the paregg for which it is ap;Mvad. If you Change, intensify or move the use to a new location, a new Zoning Cleprenae will be n§quirad. I hereby certify Thal I own or have the owner's permission to use ilia space indicated on tht; approation. 1 el5o certify that the Information provided is We and accurate to the best of my knowledge. I have read the• conditions of approval, aid 1 understand CAM. and that I WR abide by them. SignatureC Printed A Ad rekv I -fa c 4 r]r n, ................................................ ............. Approved as proposed ( ) Approved with conditions rb a CL Building Official Date Zoning Official Date /2005 09:29 FAX 434 972 4126 BLD CODE & ZONING 2002 Applicant to complete the following: Y1 N Do you have one of the following: r Tax Map and Parcel Number and or; Address of use (include unit or floor if opproprlate; ©1 N Do you have a Floor Plan (sketch or an architectural drawing) that includes the following: T ire total square footage of the use and/or; Tb_ quare footage of each room or area of u:3e: ryryo 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. Y 1 Will there be food preparation? If so, give applicant a health Department form. `r . Zoning review can not begin until we recel've approval from Health Dept. Y / N 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. Y / N Is on public water and sewer? 0 N Will you be putting up a new sign of any kind? if so, obtain proper Sign permit. Permit # &1 N Will there be any new construction or renovations? If so; Otain the proper Permit. Permit # Y / fO Is this for sales of Fireworks? If so, obtain a copy of F/R permit. Permit# Zoning Tech to complete the following: Violations: Y / N 11 so, List: Proffers: Y / N If so, List: Variance: Y / N If so, List: SP's Y / N If so, List: Reviewer to complete the following: Square footage of Use: Y / N Permitted es: Under 'Section: Supplementary regulations section: Parking formula: Rewired spaces: Y / N Items to be verified in the field: Inspector Name & Date: