HomeMy WebLinkAboutCLE200900037 Review Comments No Submittal Type Selected 2009-03-16-- .
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A IicatU for Zonin Clearance
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Zoning Clearance- -_ $35
OFFICE USE ONLY
Check #
_ _
PLEAX REVIEW ALL 3 SHEETS
_ _ - Date:_
Receipt # Staff:
PARCEL INFORMATION
Tax Map and Parcel: Existing Zoning
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- Parcel Owner:
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Parcel Address-V/(;, "c7 Citcift �,° State `/ Zig%
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? clz5^ A..)
-
Address: %(y Zee 2 A1,9 )E> City 0 State 0 ot5l, Ziap7MC --,
Office Phone: "� 'Cell # �a S /S_3 Fax # E -mail 7A -
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use . Change of name ew business
Business Name /Type)vz—,—Z- ,t-,,y,S�:z:a V-- Z�A &--_roc
Previous Business on this site
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: 91/�t� ; 'T� l�
*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 ahem, and that I will abide by them.
Signat e LL Printed Ape,
APP VAL 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 ®`(�
Zoning Official Date 3 ►6 04
Other Official Date
t -ounty of . aunemarie impartment 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