HomeMy WebLinkAboutCLE200500110 Action Letter 2017-08-0109116 FAX 434 972 4126 BLD CODE 8e zoxING
14001
4 plication - for, Zoning Cle
❑ Zoning Cieurance - S35
PLEASE REVIEW ALL 3 SMETS
PARCEL R�'ORA'IA�TION
Tax Map attd Parcel: D ! 1'f'i (1 - 4 Z b O ! Zfiain
Parcel Address: �J' !� S17 d P Ptr-r I-,14TY1*4Cjtv' j�� ( ,State
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A.PPI.ICANT TNFORMA,nO�N � � W/�'DIt° ��?5 � Ej�y 9 �I G�-CS
Who 3houid we Ca21write Cenlerni this re aCt?
Addre" 6 D,,D,OZ41.4 A)t1Z ty r 11�_State r,9' zlp '
Oifece Phone: # Paz # �-91
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PROJECT EMRMATION
Rrt$iAgn Narne/Typct
.frevlous Suss Bess an this site:
proposed ow- 5 -- -2- — — IV' 4 V 4QS
Circle (if appkable). FkCWDF6 / ChriSUMS TM . - If
SEE COMMONS OF APPROVAL IF THE CLEAVANCE 13 FOR FMWOMC Olt CHALSTM" TRU SALES (Shea*)
"'Phis Ckaratroe will only be valid on the paml for vihidi it is approved. WYeu ehan0e, tatensffy or move the an to a reew lowden, a new Zoning
Gluts wUI be tcgWtcd.
i hemhy oerlify ghat 1 own or have the ropers permission to use the now ladkded wi this appltmedvu, I ado certify tW the iu lb=tion provided Is
true end actuate to the boar of my Imawledga I ikvro rend the aottditioea of approval, and I anderslattd &CM and to 1 will abtdv by them.
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3igztattu+e Printed ey /U /-/0w-kS7;0
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APPROVAL UWMRMATTON
( ) Agprwed a p- --sed
,A..1,- --7
witk amdidons
Building Official Date
Zoning Offiew 40J97= Zf Date ry Vs
v.
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Other OfiieW Date
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Coaaty of'AlhemarlewDepartment of Community Development r..---
40I XclQUre Road CUrlottewMe, VA 22902 Valeet (434) 2964W2 Fax.: (434) 9;2-4I26
UP
Oiii2i2•008 00:28 FAX 434 972 4126 BLD CODE & ZONING
Q 002
Applicant MUST HAVE the Following information to apply:
Tax Map Pad parcel ar Addrems wi& unit u miw Or floor if appmpriat&
)' Floor Plan - alltlidr a sketch or an architecan-al drawieg
e) If using less tUn the entire stmetmra, note the locatiop will in the strwcftw,
b) Ncft the total square footage of the Use;
a) Note the square footage of etch room or acre of use;
d) Now Ehe uw 9f each maxuar ama of use_
Iutukm to complete the fallowing:
Y /9 Is the use in a LL HI or PDW zoning?
If so, give applicant a Certified Eagincees Report (CEN packfL
Cats not issue until CEX to approved by the County Engineer.
Y Will tisate be food preparation?
If so, fax application to HeWt1L ))eparmmt. FAX DATE
Can not issue until we receive approval fromBeakh Dept.
Y IO Ia theparcel on private wail end septic?
If so, Am application to Health Department FAX DATE
CM not issue ++util we receive approval f -am Health Dept.
)I N Is the parcel as pt fie Wafer and sear &
Y/NO
Y�
YIjNj
Will ym be putting up it new sign of any kind?
If so, obtain proper Sip permit. Fern* # - —^
WW there be any ucw constmc ion ar re vndons?
If so, Obtehe the pepper Permit. Permit At
Is this for Bales ofFheworks?
If to. abWA a copy of Flit permit. Permit #
Znning Teets to complete Me following:
Y 1( �Y' Aso, List:
Y j N It so, List
Reviewer to complete the fallowing:
Y",/ IPsa, List:
If so, List:
square footage of Use: :22A>P Permitted ss: j --
Under Section: Supplea&9tary rl;gulatiemg Section: --�
Faikint formals' Required spaces: c". ( 40effg Cdrf
Y I== to be Vedfied in ttu Held:
3