HomeMy WebLinkAboutCLE200500163 Action Letter 2017-08-01application for Zoning Clearance
OFFICE USE O cc s
❑ Zoning Clearance = S35 CLE #
Check # 430a Date:
PLEASE REVIEW ALL 3 SHEETS Receipt # Staff:
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PARCEL INFORMATION ��ii/�y
Tax Map and Parcel: `��60 00 — b ✓b Existing Zoning
Parcel Owner:
Parcel Address:
__(include suite or floor_
State tl"�' zip4e! l
APPLICANT INFORMATION
Who should we call/write concerning this project? % l
Address: Q City 011 SI�I�/� State zipg��
Office Phone: �M 9'3R-3-TS6 Cell # SY() ff-Y%7F ax # #/- !?-?1 %& E-mail
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 ownees 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 r Printed �T
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APPROVAL INFORMATION
( Approved as proposed C% Approved with conditions
Building Official Date G oS
Zoning Official Date -? D
Other Official
Date
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Y County of Albemarle Department of Community Development ------------------------------
3%3/?005 Page ?� f 3
Applicant 1 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 j
,R a) If using less than the entire structure, note the location within the structure;
/ J b) Note the total square footage of the use; j
CCCJJJ c) Note the square footage of each room or area of use; 4I
d) Note the use of each room or area of use.
Intake to complete the following:
Y I�Is the use in a LI, HI or PDIP zoning?
If so, give applicant a Certified Engineer's Report (CER) packGt-
Can not issue until CER is approved by the County Engineer.
Y 1 VWill there be food preparation? If so, fax application to Health Department. FAX DATA '
Can not issue until we receive approval from Health Dept. 1
Y 1 hl 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 #
Y I(9Will there be any new construction or renovations?
If so, obtain the proper Permit. Permit #
Y INs this for sales of Fireworks?
If so, obtain a copy of FIR permit. Permit #
Zoning Tech to complete the following:
Vi as:
Y If so, List:
i
I
a 'ante:
Y 1 4 If so, List
I Reviewer
Square footage of Use:
Y t N If so, List:
the following:
ZOW Permitted as:
If so, List: qr�k r7
Under Section: 22. , 2 . L '1 Supplementary regulations section:
Parking formula: ( d` ?0 . : ao0 Required spaces: y
Y 43 items to be verified in the field: