HomeMy WebLinkAboutCLE200500207 Action Letter 2017-08-02Albemarle County Department of Community Development
Fee of $35.00 File #: �
Application for check#(rc�q Date:
Zoning Clearance Recept# Staff;
Tax Map/Parcel:
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Parcel Owner:
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IL ,o Address - 9
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(include suite or aor)
City LState Zip
Existing Zoning:
Who should we call/write concerning this project?
ro Address ��p �-t{[,i 1 City y State �,)a Zip
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a � Office Phone: �.O Cell:
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Fax: E-mail:
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c Business Name/Type: ��{�5-� 6 PRz)F—N)
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Previous Business on this site:
Proposed use: RC—S} .
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Circle (if applicable): Fireworks 1 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 a new location, a new zoning
Clearance will be required.
I hereby certify that 1 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.
Signatur °.J J-- Printed �, .�-�„`�„��}
------. ..._.._.A ...................................... . ---- �� ----.....-----.......--------.._......
--.-...--. ----- pproved ------
( )Approved as proposed { A roved with conditions
Building Offici
Zoning Officia
_Ii
Date
Date
Applicant to complete the following:
N Do you have one of the following:
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
J N Do you have a Floor Plan (sketch or an architectural drawing) that includes the following:
J 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 `lJ Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CPR) packet.
D! 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.
YN 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.
YDY
' N Is on public water and sewer?
N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit.
Permit #
N Will there be any new construction or renovations? If so; obtain the proper Permit.
DY
/71\ Permit #�
Y /[ N) Is this for sales of Fireworks? If so, obtain a copy of FIR permit.
�J Permit #
Zoning Tech to complete the following:
Violations:
Y/I :N�:)
If so, List:
Proffers:
Y 1�9
If so, List:
"!
Variance:
N
If so, List:
SP's
N
if so, List:
Reviewer to complete the following:
_7� N
Y ( items to be verified in the field:
Inspector Name & Date:
Square footage of Use:
rMIPA^ • Under Section: 2'1
Reauired spaces: