HomeMy WebLinkAboutCLE200900023 Review Comments Zoning Clearance 2009-05-08i
for Zoning_C1earance
__-Application
- -GLE- - -
OFFICE USE ONLY
❑ Zoning Clearance = $35
Check # Date: -
PLEASE REVIEW ALL 3 SHEETS
Receipt # ` Staff:
PARCEL INFORMATION 1,
Tax Map and Parcel: �"� Existing Zoning
f
Parcel- Owner: - -- -- --
Parcel Address: Ci State Zip
(inc ude suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? R"11YJlL� ��i
Address : City State Zip
Office Phone: Ce # Fax # E -mail
APPLICANT INFORMATION -. -_ - -- - -
Check any that apply: Change of ownership Change of use Change of name New business
Business Name /Type:
Previous Business on this site
Describe the proposed business including use, number of employe,e,� nu ber of shi , available parking s aces, number of
��
vehicles, and any additional information that you can provide: � uran j 24 .$g . .
*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 �J �'` X Ih Printed
-A—PP ROYAL 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.
[ ] 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 a l
/ yb
Zoning Official Date
Date
Other Official �(
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