HomeMy WebLinkAboutCLE200500150 Action Letter 2017-08-01p - y'
ApplicatioA for Zoning Clearance mvi
��,,,,��' OFFICE USE ONLY
IKZoning Clearance - 535 CLE # Cca�L`.>e7s /5D
Check # 7/_3 G . - Date: S- -0
PLEASE REVIEW ALL 3 SHEETS Receipt #-- Staff: Etj
PARCEL INFORMATION
Tax Map and Parcel:- CGe o(-, .- C p 2�c3Q Existing Zoning C` C 4'►r►�m ci
Parcel Owner:
Parcel Address:= S UJ . T_6r,-c L1 - 12J' City �► J� tL, State V41 zip '7Z "10 I
ifnclude suite or floor)
........................................................................... -----------------
APPLICANT INFORMATION r C
Who should we caWwrite concerning this project?
Address: (q(a u C� P � 2,j City State _ YG_ -.�Zip Z 7
Office Phone:1-"� -)-q C1 G 0- 5.7 2. , Fax #
E-mail
PROJECT INFORMATION
Business Name/Type;�'�.s.�
Previous Business on this site: Qom_ sr-y 191 Z t�- +-4U-r'e---
Proposed use:
Ic
Circle f if applicable): / Firewor / Christmas Tree
SEE CONDITIONS ORAPPROVAL 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 cent* that I own or have the owner's permission to use the space indicated on this application. I also certify that the infon-nation provided is
true and accurate Itostnowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed�:'�� �•., t �-. �"�
APPROVAL INFORMATION
( ) Approved as proposed
Building Official
Zoning Official
( ) Approved withconditions rl.ECE ED
Date C. ( v
z
Date SL3 q as
J'QC e#hfficini
Date D�"AZ-oS
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County of Albemarle Department of Community Development
31 2005 Pa-ge 2 of
Applicant MUST HAVE the following information to apply:
1) 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 less 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 IN Is the use in a LI, HI or PDIP zoning?
If so, give applicant a Certified Engineer's Report (CER) packet.
Can not issue until CER is approved by the County Engineer.
Y ON
Will there be food preparation?
If so, fax application to Health Department. FAX DATE
Cannot issue until we receive approval from Health Dept.
Y / 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.
Y /P Is the parcel on public water and sewer?
Y / X Will you be putting up a new sign of any kind?
If so, obtain proper Sign permit. Permit #
Y / Will there be any new construction or renovations?
If so, obtain the proper Permit. Permit #
N Is this for sales of Fireworks?
If so, obtain a copy of F/R permit. Permit #
Zoning Tech to complete the following:
Y 1/ N )[ff so, List:
so, List
Y"- LKso,'List:
Y A N !If soy List:
Reviewer to complete the following:
Square footage of Use: Pennitted as:�iYlct/1
Under Section: c J� �1 u ' Supplementary regulations section.:
Parking formula; - 1fi Required spaces:
Y. /\� Items to be verified in the field: