HomeMy WebLinkAboutCLE200900095 Review Comments Final Zoning 2009-11-03J
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Application f-or -Z.own =cclear -any
® Zonin Clearance - $35
OFFICE USE ONLY n
Check # G�%7 5 Date: / - -
Receipt Staff.
PLEASE REVIEW ALL 3 SHEETS
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— PAffCEI� IlSFOIt1GrATiO IN
Tax Map and Parcel: Existing Zoning_��?���•_
parcel- Owner: �C7 fi�1'%f --z 71n' —�-1.
Parcel Address: 4(66 Enn-6 -� (W AQ City G �! � S�a�ie State Zip
(include suite or floor) 4S,+ f -oov-
PRIMARY CONTACT
_Who should we_calllwrite concerning_this project?
Address: " A ek &o ct -_ City State VA, Zip k - IS71
Office Phone: 1111 Cell # Fax # C1CmaC.Cw,
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name /Type: 1 f k ay l olk Vc O i' h A k K i5 - L AV I i4 OC .
Previous Business on this site A o
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:
*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 them, and that I will abide by them.
S ignatffe e Printed - --- - L4g7z A ,'6td'/ -
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, xl 19.
[ ] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing
site plan.
[ J This site complies with the site plan as of this date. q
Notes:
Building Official Date _ -a
Zoning Official - -- Date 1
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