HomeMy WebLinkAboutCLE200900088 Review Comments Zoning Clearance 2009-06-10Appheaton for Zoning Clearance
CLE-
Zoning Clearance,= $35
OFFICE USE ONLY _
Check # Date:
- PLEA E- VIEW ALL 3 SHEETS -- - --
Receipt # 5! Staff-
PARCEL INFORMATION
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Tax Map and Parcel: (') 6 [ ULO — 01 — O 0 — 0 12 Existing Zoning
Parcel Owner:1
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Parcel Address: �2fe:^Cl�whr 1),r City Ckkow L�A_ State �,� Zip s
(include suite o*r floor)
PRIMARY CONTACT Aif,
Who should we call/write concerning this project? 5&&
Address: X55 )SUJxL r Afg_ City C, [WL4� VA_ State V l°� Zip
Office Phone: L%) CJJ '� (oCb ( Cell # 53 i .)LJ 3 J Fax # Q -T -613Z_ E -mail
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APPLICANT INFORMATION
Check any that apply: Change of ownership Change use r�"� Change of name New business
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Business Name/Type: 4P.�'r°�fA z_ {��a2.v w ra J i, C 1 v-�N
Previous Business on this site
Describe the proposed business including use, number of employees„ be of shifts, available parking spaces, number of
vehicles, and any additional information that you can provide: v
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*This learan& wit 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 accur to the bes f owledge. I ave read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed SCAC
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 o
Zoning Official 4 Date [v I,6
r
Other Official Date
County of Albemarle department oI t.ommumty Leveiopment
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 04/28/08 Page 2 of 3