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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: