HomeMy WebLinkAboutCLE200900012 Review Comments Zoning Clearance 2009-02-06- Application forrz-oninLy Clearance-
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- -] Zoning Clearance — $35
OFFICE USE ONLY
Check # t C v
PLEASE REVIEW ALL 3 SHEETS
Receipt # Staff: i
PARCEL INFORMATION �—
Ofvl C�- 61- � _ /3/ � i
Tax Map and Parcel: Existing Zonin
Parcel Owner:
Parcel Address: /( /U /7%t/ 19P City l / !' ,6tate V147- Zip 270,
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? �,04- f w4na.J n
Address r >4g -T�jgeE Ai gt w&,2 City 15a /in;b l6t State V14 Zip
Office Phone: Cell # .3 ,Lf- 6°-&`3 ?f Fax # E -mail ijl f}i^}- '40 H4fflasC, 60
r l i q3 91V j
APPLICANT INFORMATION
Check any that apply: fir/ Change of ownership Change of use Change of name New business
Business Name /Type: (—/ a,,�z �c92)
this I
Previous Business on site t _
Describe the proposed business including use, number of employees, n mbe of shifts, available parking spaces, number of
-Ftila S4t--
vehicles, and any additional'information that you can provide: Gtr--
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*'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 r�u--- Printed ti.t' i" l
APPROVAL INFORMATION
Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, x119.
Jam] 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 ;W i
`
Zoning Official Date
Other Official Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 04/28/08 Page 2 of 3
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