HomeMy WebLinkAboutCLE200900057 Review Comments Zoning Clearance 2009-04-23- -- - -- -Application for Zoning Clearance---
- _OFFICE USE ONLY, — - -
Zoning Clearance = $35 Check #
ID Zy { • ��j
Date:
PLEASE REVIEW ALL 3 SHEETS Receipt # ') Staff•
PARCEL INFORMATION
-
Tax Map and Parcel: - "'j�,y� Me- p "I 5 e '"n �� �•tr � Existing Zoning
Parcel Owner: ✓5 L % ��•i #- " ?� , y
Parcel Address: 130 / S e fvt i na f te, e ro—, I City Ci� �1� '1 �!� State (A Zip ZZ�i /
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? 1�SG� GCU- '
Address :-3 C04- City State �;�� Zip �? 0 j
Office Phone: (' N 91k, .?34 -) Cell # -',Iqa 0'77 Fax # 1711 -739 4 E -mail
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name/Type: ,S i AA J) kq I� ii 2 5 {� v G
Previous Business on this site
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
v hicles, and any additional information that you can provide: Re� r AtA 4 io' — ®*e(V C-
*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 ha read the conditions of approval, and I understand them, and that I will abide by them.
Signature ; ,o Printed I3 rc d
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 4"1 —OA0 - C�
Zoning Official Datef Z,.��? J
Other Official Date��
i -7 S —,n7---1
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