HomeMy WebLinkAboutCLE200500167 Action Letter 2017-08-01Application for Zoning Clearance ta,[�iek'�'
❑ Zoning Clearance = S35
PLEASE REVIEW ALL 3 SHEETS
An
OFFICE + ONLY
CLE #
Check # Date:
Receipt # Staff -
PARCEL INFORMATION .
Tax Map and Parcel: --*h Existing Zoning �f
Parcel Owner:_
Parcel Address: City chill/�d ff�s�:P State y Zip ;z ? 9/J
include suite or floor ----------------------------------------------------------------------•-------
APPLICANT INFORMATION y _
Who should we call/write concerning this project?�6k
Address: .�J` o� Sc,,;, a I,— fi a r City C A ae-C ffe5&47/"-State _
Office Phone: x 9 7S=32 7SCe11 #Vf 9LYYfJ_YFex # M974ft_E-mail
VA zip Sl/
PROJECT INFORMA,JON
Business Name/Type: ovAb1c Av C V Pil &-r,'itf'S _�,f Il°S
Previous Business on this site: 'e�rif 1A o f _rjo d� S
Proposed use: klebtfV
6reer-,7h rs /- tpi s_7'�d I/!a's
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 owner's 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 Printed "Aft 0- �eSe'irc� F J %.
/ ------------------------------- -
APPROVAL INFORMATION
"
proved as proposed Approved with conditions
Building Official �^ Date C. ( Ls koQx
Zoning Official Date
Other Official Date
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County of Albemarle Department of Community Development
Applicant MUST HAVE the following information to apply:
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 IGN Is the use in a LI, HI or PDIP zoning?
If so, give applicant a Certified Engineer's Report (CER) packet.
f'� Can not issue until CER is approved by the County Engineer.
Y Il Nl Will there be food preparation?
�/ If so, fax application to Health Department. FAX DATE
Can not issue until we receive approval from Health Dept.
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.
1 N Is the parcel on public water and sewer?
Y 1 N Will you be putting up a new sign of any kind? f�
If so, obtain proper Sign permit. Permit #
Y a Will there be any new construction or renovations?
If so, obtain the proper Permit. Permit #
Y IOU this for sales of Fireworks?
If so, obtain a copy of FIR permit. Permit #
Zoning Tech to complete the following:
Violations:
1 N If so, List:
Variance:
Y I N if so, List
Reviewer to complete t AM
Proffers:
Y 1 N If so, List:
J ! N If so, List:
Square foo'lagettW Permitted as:
Under Section:. ZZ • Z ' l 1 Supplementary regulations section:!
Parking formula: 4bd 4 �Slj�Aupd Required spaces:' +- C,Le 2 5
Y Items to be verified in the field: