HomeMy WebLinkAboutCLE200500093 Action Letter 2017-08-01Application for Zoning Clearance
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OFFICE USE O
Zoning Clearance = $35 CLE #
Check # Date:
PLEASE REVIEW ALL 3 SHEETS Receipt # Staff:
PARCEL INFORMA'
Tax Map and Parcel:
Parcel Owner:
Parcel Address:
Mite or floor) ----
Existing Zoning_PDW
City State I Zip m
APPLICANT INFORMATION
Who should we call/write concerning this project?
Address : City State Zip
Office Phone: L__) Cell - ax # E-mail
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PROJECT INFORMATION 4
Business Name/Type:
Previous Business on this site: WWI � - 6��
Proposed use: 104
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Circle (if applicable): Fireworks / Christmas Tree
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet3)
*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 the information provided is
true and accurate to the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them
Signature Printed Go
APPROVAL INFORMATION
( ) Approved as proposed
( ) Approved with conditions
Building Official Date
Zoning Official Date
Other Official Date
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County of Albemarle Department of Community Development -
3/3/1UW rage t Or 3
Applicant MUST HAVE the following information to apply:
�q Tax Map and Parcel or Address with unit number or floor if appropriate.
2) A Floor Plan - either a sketch or an architectural drawing
a) If using Iess than the entire structure, note the location within the structure;
b) Note the total square footage of the use;
c) Note the square footage of each room or area of use;
d) Note the use of each room or area of use.
Intake to complete the following:
Y / N Is the use in a LI, HI or PDIP zoning?
If so, give applicant a Certified Engineees Report (CER) packet.
Can not issue until CER is approved by the County Engineer.
/ N Will there be food preparation?
If so, fax application to Health Department. FAX DATE
Can not issue until we receive approval from Health Dept.
Y Q Is the parcel on private well and septic?
If so, fax application to Health Department. FAX DATE
Can not issue until we receive approval from Health Dept.
/ N Is the parcel on public water and sewer?
N Will you be putting up a new sign of any kind?
If so, obtain proper Sign permit. Permit #
N
Y)N
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.
Zoning Tech to complete the following:
Violations:
Y / N If so, List:
Variance:
Y / N If so, List
Reviewer to complete the following:
Permit #
Proffers:
Y / N If so, List:
SP's:
Y / N If so, List:
Square footage of Use: Permitted as:
Under Section:
Supplementary regulations section:
Parking formula: Required spaces:
Y / N Items to be verified in the field: