HomeMy WebLinkAboutCLE200500121 Action Letter 2017-08-01Albemarle County Department of Community Development
Fee of $35 00 File M ' ` / dy,
Application for Check# t/a r?qL/
Date
Zoning Clearance Recept# G stagy:
Tax Map/Parcel- - 1! C r7
1 ro Parcel Owner /
4 € Address 04 s y �¢� City �,.�.,% , State Zip a 2 y//
(Includ suite or floor)
Existing Zoning:
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Who should we call/write concerning this project? het Ak. Ake- t4, oo,,
z Address (9- K r v aar.tj,eal r^, City a/'#Jr v'14tate VAI Zip 2 Z1j //
q o Office Phone: LIS1 a r Cell:
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Fax: _226 - _9Sf 0 E-mail:
Business Name/Type:
Previous Business on this site:
Proposed use: j - U w. ;
Circle (if applicable): Fireworks 1 Christmas Tree
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`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 Zoninp
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 W the best of my knowledge. I have read the condl#lons of approval, and I understand them, and that I will abide by them.
Signature Il't, Printed S'itP4EW
Approved as proposed ( ved with conditions
Building Official b,
Zoning Official
Date j '.' j
Date
Applicant to complete the following:
�1 N Do you have one of the following:
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
a)/ 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 1 N 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 1 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.
Y 1 N Is on public water and sewer?
Y 1 N Will you be putting up. a new sign of any kind? If so, obtain proper Sign permit.
Permit #
Y 1 N Will there be any new construction or renovations? If so; obtain the proper Permit.
Permit # _
Y / N Is this for sales of Fireworks? If so, obtain a copy of FIR permit.
Permit #
Zoning Tech to complete the following:
Violations: Y N If so, List:
Proffers: Y 1 N If so, List:
Variance: Y If so, fist:
Spy$ Y N 1f so, List:
Square footage of Use: *7 2-7Reviewer to complete the following: q g
O1 N Permitted as:
Under Section:
aetions.seciion
f . _ VA'*Kk , di.=too Required spaces: 5
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Y Items to be verfied.in the field: Q"'
Inspector Name & Date: