HomeMy WebLinkAboutCLE200900044 Review Comments Zoning Clearance 2009-03-30Appl- cation -for- -on n , - C- ance- -
[Zoning - Clearance = $35
OFFICE USE ON Y l
Check # Date: s L
PLEASE REVIEW ALL 3_ SHEETS _-
Receipt # — - - _ _ - - -- Staff:
PARCEL INFORMATION
Tax Map and Parcel: Existing Zoning✓%%
- Parcel - Owner: - - ' - -` -- - - l - - - -- --
ynParcel Address: ,� Lr L ✓ - � C� City y jy �a611 State Zip G.
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? 4 1 i (Z\ S, z r
Address: _t_>tcMlrs . City �ro Cir.c iyi �� State`p ZiP��l(1
0��2
Office Phone: - Cell # G13 y- � &�?- Fax # . --"" E -mail -1�)4u r
APPLICANT INFORMATION
Check any that'apply: Change of ownership Change of use "Change of name u#,O" New business
Business Name /Type: On M 4 _1 n, S 1-1. + C, � C in a r` IA. -r- K
/���P
Previous Business on this site 1 /"/ ,o ,n/ ;',9 f �Cr CA J C 0 /- i� � , "�
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: M A ; c ) A c);.c
4C� P�f�tcv� �%aG'C —S
*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 - best of m owledge. I e read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed /2 /{; S
APPROVAL 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 Jul
Zoning Official Date c3
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
t'