HomeMy WebLinkAboutCLE200500099 Action Letter 2017-08-01Albemarle County Department of Community Development
Application for
Zoning Clearance
Tax Map/Parcel:
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� � ParcelOwner: _ _ ..c�
4 Address �.
(include suite or floor)
Fee of $35.00
Check # ! / 31
Reoept # t-2-79911
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Filet 6V _—_09 7
Date: / 7
Staff: %
City G, State U k Zip z Zq0
(Do f �,�s &*L - Z 2_R0 l Existing Zoning:_- h� C.----•-----------------------------.-----------............------------------------.... ..---------------------------- --
Who should we call/write concerning this project? M-k 2�j ae kati-Am S J. �f -.
Address iS Z City C\rt,I State 4 Zip z zc)of
Office Phone: {31 72-0 • 9901 Cell: { 4 341 `M - al s3
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Fax: W BSI- 1D$ E-mail: fY1i`Gl w 1 r K S Cl� ohs ��� .Cc
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Business Name/Type: ���� -IR, i a N 0— e-►n t-
Previous Business on this site: i A
Proposed use:
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Circle (if applicable: r Fireworks / Phrilpmas Tree ` y 4NC
17his 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. 8 r! l
I hereby certify that I own or have the armies' to a in ' ell on this application. I also certify that the information provided
is true and accurate to the best of m edge di ' of approval, and I understand them, and that I will abide by them.
Signature Printed M c_\,4 1
.....---{ )Approved as 0 oposed----------------.----( proved with conditions' ---••---•--------------- ---
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Building Official
Zoning Official
Applicant to complete the following:
`�/ N Do you have one of the following:
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
Y 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:
Y 1(N) Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet.
Y 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.
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.
`D/ N Is on public water and sewer?
t 1 N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. 0
Permit #
Y 10 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 #
-:oning Tech to complete the following:
Violations: Y If so, List:
Proffers: Y 1 N If so, List:
Variance: Y If so, List:
SP's Y N If so, List:
4eviewer to complete the following:
1 N Permitted
Supplementary regulations section:
Square footage of Use:
Under Section: J,,,,,4 z
Parking formula: Required spaces:
fe Items to be verified in the field:
Inspector Name & Date: