HomeMy WebLinkAboutCLE200900015 Review Comments Zoning Clearance 2009-02-09Ap =plic- anon - for- Zo -nin - -- C- learance
CLE_ #_
Zoning Clearance = $35
OFFICE USE ONLY
Check # �° e`7 c Date:
-_ -- -PLEA E REVIEW ALL 3- SHEETS - -- --
Receipt- # - 7v? 1pa - -- - Staff: ( ;
PARCEL INFORMATION
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Tax Map and Parcel: Existing Zoning
Parcel - Owner: -- -61A —e Ip/,� - J 1-7 y 0` V /kCl�� -- oVAe 77 %V.✓
Parcel Address- Yd u /� • c• y�7 �R�G� City 0�10 ^6770 ( C(f State i/d `/NIA Zip)_Lg b
(include suite or floor)
PRIMARY CONTACT �"'
J lzj
Who should we call /write concerning this project? / ,
Address: �A/J/l IG/!1/� �0 %ti7,F City ��N/t(e77�Ffbll�Qf State VA Zip�Z %b%
Office Phone: V7 �0 �' yO*Vkell # ��� �/ b Fax # 71-7 f a -r� E -mail c��� �W A ��R��'�i/►�. Tr h
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
-- ' V114
Business Name /Type: 0,zr/( 5r
Previous Business on this site
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, umber of
vehicles, and any additional information that you can provide: O)cr /of 41'—,-1VjeV --7-a
*Thus 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 ad the conditions of approval, and I understand them, and that I will abide by them.
Signature t Printed .��'r%!'��� /�/� �i✓r/�.iU✓"
AP ROVAL INFORMATION
Approved
[t, as proposed [ ] Approved with conditions [ ] Denied
[ ] Backflow 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: -ZPMA 2-W44--)0
Building Official - Date1i
Zoning Official Date of
Other Official Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 04/28/08 Page 2 of 3