HomeMy WebLinkAboutCLE200500089 Action Letter 2017-08-01Albemarle County Department of Community Development
Fee of K5.00 File #:
Application for Check# a a Date: 6:5—
Zoning Clearance Recept# Staff � _
Tax Map/Parcel:
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Parcel Owner.
.
4 Address _%/ K YeW1X1We,' _ 7,405"G _ City �IDT/ 'G State a Zip
(Include suite or floor) 6�k4p
Existing Zoning:
Who should we call/write concerning this project? 01W 01rIM4 MWXX s
fi ,o Address �� JT City O/ %WA%W4tate Zip
� Office Phone: � 7 ��� � Cell:
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Fax: Y 3Y 6719 E-mail: A%mLeyl- CDfi� _
Business Name/Type:
P. /A/ /f/
Previous Business on this site: A D%d.47p
Proposed use:
0
`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 kxstion, a new Zoning
Clearance Wit be required.
I hereby certify that 1 own or have the owner's permission to use the space indicated on this application. I also certify that the information provided
is true and a to to the best of my knowledge. I have nod the conditions of approval, and I understand them, and that I will abide by them.
Signatu Printed fut.
...............
-------- } p- ved.es proposed--------------------------1�1 A..........................................
provedwith conditions ---------•••••-----------------
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Building Official Date 6
Date
Zoning Official S S
Applicant to complete the following:
CY)/ N Do you have one of the following:
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
V 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 looation within the structure.
Intake to complete the following:
Y /S Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet.
Y %N� Will there be food preparation? If so, give applicant a Health Department form.
0 Zoning review can not begin until we receive approval from Health Dept.
Y /0 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 16) Is on public water and sewer?
Y /(9 Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
LL��// Permit # _
Y 1/N J Will there be any new construction or renovations? If so; obtain the proper Permit.
�/ Permit #
Y /6) 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 If so, List: -
Proffers: Y N If so, List:
Variance: Y 1 N If so, List:
SP's Y I N If so, List:
Reviewer to complete the following:
C$ / N Permitted as:
Square footage of Use:
Under Section: o J __
Supplementary regulations section:
Parking formula: Required spaces:
Y / tD Items to be verified in the field:
Inspector Name & Date: