HomeMy WebLinkAboutCLE200900016 Review Comments Zoning Clearance 2009-02-06Application for Z_o g_Clearance
110
CLE #
Zoning Clearance = $35
OFFICE USE ONLY ✓''
Check # 1-50fl Date: � �'�;� (✓
-73q,92
PLEASY REVIEW ALL 3 SHEETS
Receipt # Staff. J1110
PARCEL INFORMATION �y
Tax Map and Parcel: -700(1-7 _7E , /_Y _'7 7" q Existing Zoning J
Parcel Owner: J ,F j PrDc , es
Parcel Address: 30a - & _ ay (`'i State \i► Zi c F
(include suite or floor)
PRIMARY CONTACT '
Who should we call/write concerning this project?
Address :3-0a , , �'
ity�I1:TtT�V i C`State Zipa; I 1
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Office Phone: ( q9i _)Cell # `t Fax # 'f,2�i4 E -mail 1GISISCYn,
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APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name "New business
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Business Name /Type: � 1 � 1� "t YY� � "ice!' i `ff�J Y �u'1(�°l� e, IUD_ i C
Previous Business on this site WA
Describe the proposed business including use, number of employees, number of shifts, available parking spaces number of
vehicles, and any additional information that you can provide: s C- i
*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 wl abide by them.
Signatur d_ " 0&&am Printed C"C-C"t-1 ~ 1"iobal\1 OYA
APPROVAL INFORMATION
/Approved
[ ] Approved as proposed [ 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 sitp�la�omplies with the si e plan as of tl-�}}i,s date. ,
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Notes: Wtt`ICe U�YI &-E— b►' c4 x4m dnc'5 rGfdf. area Lu 02 yheprf
Building Official - Date � M
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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