HomeMy WebLinkAboutCLE200900006 Review Comments No Submittal Type Selected 2009-09-23-_ -- - __
Application for Zoning Clearance
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OFFICE USE ONL
[9�oning_Clearance = $35
Check # Z `: Date: 9 lat,
PLEASE REVIEW ALL 3 SHEETS
Receipt # 173,ZA ✓Zj Staff:
PARCEL INFORMATION - -- _ — –
Tax Map and Parcel: ,4-15 le� Existing Zoning
Parcel Owner:
Parcel Address: l % r-Cc f City �_i( State Zip
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project?
Addr® %i � -- - -ity
Zipss � s
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Office Phone: HA a�5- 1.�Qoo1 3� E- maili�cnr�S{v�
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name/Type: A V_V'V:51s R i .5 r��R -%e �� f - [ � C_' z> -4-^4
Previous Business on this site
Describe the proposed business including use, number of employees, number of shifts, available parking sp ces, number of
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vehicles, and any additional information that you can provide: � s� sz 2� to .2 eS o
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*This Clearance will only be valid on the parcel for which it is alVroved. 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 —
APPROVAL INFORMATION
Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Baclflow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, x119.
[ ] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing
site plan.
[ ] This site complies with the site plan as of this date.
Notes:
Building Official - Date d fJ3 �i
Zoning Official Date I l a �J
Other Official Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 9724126
Revised 04 /28/08 Page 2 of 3
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