HomeMy WebLinkAboutCLE200500071 Action Letter 2017-08-01Albemarle County Department of Community Development
Fee of $35, 00 File #: 6 ROD,5-0 /
Application for Check # 1,2vl Date:
Zonin g Clearance Reoept# �q Staff.:
Tax Map/Parcel: 0 J CQ ' b 0�.
t
Parcel Owner: �/Mjll
� di
a € Address w4 4 4/� •fit 4C �o rr/ti d City �V+ �� State 1� Zip
(Include suite o flo ~
Existing Zoning: p
Who+should we calltwrite concerningthis project? �1 ° �r'11 ..-. ll 4 +y`� .
W' I
Address )0,o ofo x (d23 r City
Office Phone:
Fax:
-r,el Y 3'X r - OY 0 0 Cell:
Business NametType:
E-mail:
State 06 Zip
r1le-4
............................................... --------------------------------
Previous Business on this site: s4% r\
a r
Proposed use: /,r LY
Circle (if applicable): Fireworks I 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 t n permission to use the space indicated on this application. I also certify that the information provided
is true and accurate to the be edge. 1 have read the conditions of approval, and I understand them, and that 1 will bide by them.
Signature r^.41 Printed t% aJ
( )Approved as proposed �( Approved with conditions- I
e
0
ro
aBuilding Official
a
Zoning Official
Date I —
Date a
r
Applicant to complete the following:
0/ N Do you have one of the following:
Tax Map and Parcel Number and or,
Address of use (include unit or floor if appropriate;
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:
Y1N
YIND
Y /�
O1N
OY N
YIN
YIN
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.
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.
Is on public water and sewer?
Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit #
Will there be any new construction or renovations? If so; obtain the proper Permit.
Permit #
Is this for sales of Fireworks? If so, obtain a copy of F/R permit.
Permit #
to complete the following:
olations: Y If so, List:
offers: Y If so, List:
3riance: Y If so, List:
D's Y N If so, List:
complete the following:
10300
Y 1 ermitted as:
Square footage of Use:
Under Section:
Supplementary regulations section:
Parking formula: Required spaces:
Y 1 N Items to be verified in the field:
inspector Name & Date: