HomeMy WebLinkAboutCLE200900112 Review Comments No Submittal Type Selected 2009-11-17-- Application_ for _Zoning__Clearax�ce
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OFFICE Y l!��Y1
Zoning Clearance = $35
Check # Date: V
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- ---PLEASE REVIEW ALL 3 SHEETS ---
Receipt -# - - Staff: ym
PARCEL INFORMATION "
Tax Map and Parcel: 07800-00- 00- 055 A 8' Existing Zoning
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— Rar- eekOwner---r-f-i-C= 7'fG�, ^—icy Fi(�r, ' T sP� ^:t � .
Parcel Address: y q r IE c Ie- State M Zip
(iuclude siiite or floor)
PRIMARY CONTACT
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Who should we call /write concerning this project? _;R
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Address: W 10 PXG At(7� mvw- tl i P� City wU;(Y�UTTCsVII��. State vA. Zip 22-111
Office Phone: t( I-M) IbVI— A'l Cell # Fax # E -mail dd5m, V ?_OoI 4� a o) • Com
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name L New business
Business Name /Type: JACQUtLl'61e. C- '(M Dr}`✓-, P C�,
Previous Business on this site 1r10D11f.1
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
ivehicles, and any additional information 1that you can
y�provide:
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*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.
Signature _. Printed (%.CQL.V_( 1 _.- _ - - - -- --
AP OVAL 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 com lies with t site plan as of this date.
�-
Notes: f8 _
Building Official Date
Zoning Official Date l % 14q
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