HomeMy WebLinkAboutCLE200500173 Action Letter 2017-08-01Albemarle County Department of Community Development
EXHIBIT D File MCA � 73
Fee oi$3S.OQ ��
Application for Check# I Date: � -VS
Zoning Clearance Recept# Staff: eL 1AR7
Tax Map/Parcel 03�0b oo � y3o o
Parcel Owner:
Address
(Include suite or floor)
City Ckorlb46 State-JA Zip s
Existing Zoning: _PD11
......................................................................................................................................
Who should we call/write concerning this project? rml1rp,,
,o Address _ '"�j l(� ��I�. City clruU� I State Zip
Office Phone: Cell:40.
Fax: � _ E-mail:11/11
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Business Name/Type:
Previous Business on this site: �t } t✓ ,
Proposed use. �, G�.i � 9`,
Circle (if applicable): Fireworks / Christmas Tree
'This Clearance will only be valid on the parcel for which it is approved. If you change, intensify or move the use to anew location, a new Zoning
Clearance wiil �e 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 knowleCge. I have read the cenditiens of approval, and I understand them, and that I will abi y them.
Signat � ri- ----------nted
..................................... .. ........
ppro+led as proposed Approved with Conditions - - - - .-
Building Official
Zoning Official
Applicant to complete the following:
`t N Do you have one of the following:
Tax Map and Parcel Number and or;
yAddress of use (include un<t or focr if appropriate;
N Do you have a Floor Plan (sketch or an arch itec'ural drawing) that ir.cfudes the following:
The total square footage of the use andlar•,
The square footage of each rOO-1 or area of use;
Use of each room or area
If using less than the entire structure, note the iocation within the structure.
Intake
�to complete the following:
Y 1 c(V J is use in t.l, H11 or PD!P zoning? if so, give applicant a Certified Engineer's ;deport (CER) packet.
Y I C) Will there be food preparation? if so, give applicant a Health Department form.
Zonirg review can not begin unti! we rece; e approval from Heait, i Dept.
Y/0
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YIN
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Y IN
Is parcel on private t,vei! and septic? it so, give appl`cant a Health Department form.
Zoning review can not begin until we recesve approval from Health Dept.
Is on public water and sewer?
Will you be pug:tir.g up a new sign of any kind? If so, obtain proper Sign permit.
Permit #
'i' new CCr;StrL'Ction Or re^OVatIDnS ! I� so obtain the proper Permit.
Will there be any �Vq
Permit # P�C,
Is this for sales of Freworks? !f so, obtain a copy of FfR permit.
Permit #
Zoning Tech to complete the following:
Vioiations: Y O if so, List:
Proffers: t LJ I N V so, List: -
Variance: Y /E) 'f so, List:
SP's a/ N l` so, List: 2W
Reviewer to complete the following: Square footage of Use: _ --
I N Permitted as: rj&A under Section: 25 A
Supplementary regulations section:
Parkin formula: Required spaces: ti 3
Y /(9 Items to be verified in the field:-
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Inspector Name & Date: