HomeMy WebLinkAboutCLE200500270 Action Letter 2017-08-03APPlication for Zoning Clearance
oMCE USE 0 �Yd6VL5—
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Diu$ Clearance - $35 CLE #
Checkix Date:
pLEASE REVIEW j LY 3 Recelpt # �& &L� Staff
PARCEL INFOON P F' y �-
Tax Map and parcel: � �' a Existl � � zoulla �„ • T. - -_.,��
Pared owner:.r.. J
Parcel Address: ! Jr3 1 !� l'!D Lvd..t%-. City State Zip
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APPLICANT INFORMATION
Whd should we caWwrite cotteernlrte tots proj t:ct3 , � a� I � �( �T �n �_� r +
Addrew
` I9 " �! .?'� _ Clty , c �r I �ptate ilk zip s-
Ofsee Phone: q Fax # z-man
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PROJECT INFORMATION
Business Nanwnlype:
Previous Hudness on this site:
Proposed use: ' — e GL ® w
Cimic�if applicable): Flew arks / Chzistma Tree
SEE ComDMONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CMUNIAS TRXX SAXYS (Sheet3)
'This Ckarance vn1I only be valid on the parcel for which it is approved. If you chenge. intensify or move the use to a new location. a new Zoning
cleeranoc Vill Uo requirwd.
I hereby tettity that I own or have the ownds patnission to use the space indicated on this appikadom I also certify that the infowtatiorn provided is
true and scxurate to the best of my lntrrwledge. I have read tha conditions of approval, and I uoderstotad Om% and that I will abide by them-
si Prig
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TROVAL INFORMATION
) Approved as pmpowd ( ) Apmved with coudidow
Bunding Officrd Date
Zoning Otiirial Date _ &I' as
Other OffieW Date
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,
County of Albemarle Department of Community Development
Poomod doe io 5ad! a"120
Applicant to complete the following:
Q N
you have one of the following?
Tax Map and Parcel Number and or;
Address of use (include unit or floor if appropriate;
N
you have a Floor Plan (sketch or an architectural drawing) that
includes the following, and if so please provide it with the
application?
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.
loning Tech to com
Violations:
YIN
If so, List:
Variance:
YIN
If so, List:
the
9/28/05 Page 2 of 4
Intake to complete the following:
Yl
Is use n LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y / Will ertTi e be food preparation?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from
Health Dept. FAX DATE
Y / (R)
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, FAX DATE
t
N
n public water and sewer?
Y/N
Will you be putting up a new sign of any kind? If so, obtain
proper Sign permit.
Permit # S 24z�-O ;1—
Y / N
Will re be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
YOlor
Is
sales of Fireworks?
If so, obtain a copy of FIR permit.
Permit #
Proffers:
Y/N
If so, List:
SP's:
YIN
If so, List:
8105 PaRe 3 of A
++fewer to complete the following.-
-quAre faawge of Use:
,VIN _
Permitted as:m.a.wC
Under avian: �r�"_ r -■
5uPpIanrttwyrcgulatiansse tiara:
Perking formula: 04 AL.11.„
Y /Cjq�'
Items to be verified in the field:
Inspector Name & Da[c: