HomeMy WebLinkAboutCLE200900029 Review Comments Zoning Clearance 2009-04-14=- pplication for � =®nin Clearance
_
Zoning Clearance = $35
Zoning
- --
OFFICE USE O
Check # USE
Recei t # Staff:
� L
PLEA E REVIEW ALL 3 SBEETS
PARCEL INFORMAT O
�,� Existing Zoning
Tax Map and Parcel:
Parcel Address: !C)3 F-J, c ��3° t Ci.�_ City C 6f State Zip
(include suite or floor)
PRIMARY CONTACT
/� �'C3
Who should we call/write concerning this project? - _
�—
� State
Address 1 - City 4 '%-� �._ Zip
Office Phone: ��f� Cell #{ Fax # E -mail
APPLICANT INFO TION
Check any that apply: Change of ownership Change of use Change of name 6 , New business
Business Name /Type: Ca L t zv- �
C `1 V\-
Previous Business on this site Q M f I ✓w o
1
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: pal "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 ta.4he best of my knowledge. I have read the conditions of approval, and I understand there, and that I will abide by them.
...Signature �P.�.a'( � _ .
% Printed- _ ci C� � -
APPROVAL INFORMATION
Approved with conditions [ ] Denied
[ ] Approved as proposed
[ ] 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 sjte co plies with the site plan as of this date.
%!/626ii CO e� � �- ca,, ark Vze_ T
Notes:
s t G �k wuti ?l
- ii
Building Official Date i �-1 Z �
Zoning Official Date
Other Official Date
(Aunty oI Alaemarle mepar[menC Vl k- UM111UHILy yVVC1VFuiouL
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 04/28/08 Page 2 of 3