HomeMy WebLinkAboutCLE200900011 Review Comments Zoning Clearance 2009-02-06Application for ZoninF Clearance
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®' Zoning Clearance = $35
OFFICE USE ONLY j� ,
Check # 9� Date: `
PLEASE REVIEW ALL 3 SHEETS
Receipt # Staff: _%4.47
PARCEL INFORMATION
Tax Map and Parcel: 5S V) a-- ^'
® Existing Zoning C_ C)
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Parcel Owner. _ -r dA Yi - - -
60114ebo l:),
Parcel Address: , ) (,C1csn C21dkc City (2 hce_rk nk i tit State f Zip
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project?
Address: k0--)_o _�nra� Ce x City C�O� lt��tate y A-
jZip (��
Office Phone: N , bC ell # �j(�° -q0q 7VSFax # - -mail rja Qlh-6Ck
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
-91 — D LAIC.
Business Name /Type: rsAA l \ OV7D 'Y J:r1: ',v)') Q
Previous Business on this site
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
ehicles, and an additional information that you can provide: <OJ e. r ^
FCC 0
*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 "owledge. ave read e conditions of approval, and I understand them, and that I will abide by them.
Signature Printed rLy ® Ct :S kA cjx O/ _r-,.-e_J S
APPROVAL INFORMATION
Approved as proposed [ ] Approved with conditions [ ] Denied
] Bacicflow 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 �1
Zoning Official Date
Other Official Date
County of Albemarle Department;oI C:ommumty 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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