HomeMy WebLinkAboutCLE200900025 Review Comments Zoning Clearance 2009-08-11- Application for Zoning Clearance
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Zoning Clearance = $35
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- OltFIC -E-USE ONLY -
Check # 4, o fe Date: �
PLEA REVIEW ALL 3 SHEETS
Receipt # L12 Staff: ecc' [
PARCEL INFORMATION
Tax Map and Parcel: 1 -� �7 Existing Zoning
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Parcel Owner: 'e.Mc f% rak4_ �f4 g � n leAC r `. oa-c,�)
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Parcel Address: City 4 - a eSVJ 6 State Zip;_ 0_
(include suite or floor)
PRIMARY CONTACT
Who �4 J� QQ"�jii S ' �j'.oelai
should we call/write concerning this project? J c-t
Address -: Its ® -L -ii2 -- City— 3 �S�n - _ State CAA - - - -- Zips
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Office Phone: (") 5`55-'aq 3 I Cell # Fax # -1. 5171 E -mail
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name/Type: C o -Lck l?r- CA4.,ke
Previous Business on this site ! �c �`� 3 , �egc e c � s ,A �c ��L�S Al?e. t S yhc,o ""+ one rl a d c OA m-
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
vehicles, and any1 additional information that you can provide: rrtli� ' � Ja', fCt c iijL�r �
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 Imowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed :::5 10 /j 00
APPROVAL INFORMATION -
[/Approved as proposed ! [ ) Approved with conditions [ ] Denied
[ ] Baclflow 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_eoplwith the s e pla of ate.
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Notes: F t� [ !
Building Official Date to-(
Zoning Official Date f
Other Official I 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