HomeMy WebLinkAboutCLE200900114 Review Comments Zoning Clearance 2009-07-29r. - — -- _
Application for ZoniN-Clearance
CLE # 200q '-
Clearance= $35
OMCE ITSE a NLY
Check # Date:
PLEAZoning
REVIEW .ALL 3 SHEETS
Receipt # 5 i,� Staff: U '`
PARCEL INFORMATION ,� �%
-' � 00
Tag Map and Parcel: ( Existing Zoning
66C,
Parcel Owner:( (( {�) _ p
Parcel Address: � U � U) 6 p6 Z City V � f {i �/ �% State � '' " Zip 2 �
(include suite or floor)
PRIMARY CONTACT .!
this C_ o re l 4 m }�)
Who should we call/write concerning project? 1� �
Address: I ' "' [ _l �1 [� l(� ! A(� CityC ( j'j/�(� o State 1� I YGn l r� 1 Q ZiP
Office Phone: (_ Cell # Do44 lx)I+o&Fax # %4353 O A E -mail h[I(I l+ +r1k br WhAi &U
APPLICANT INFO TION
Check any that apply: V Change of ownership Change of use Change of name New business
Business Name/Type: t 1`) `��(' �� I Gl I L 5� ��.. rj< e i +a
Previous Business i' D A �j�✓
on this site�'G t_
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
information hat
vehicles, and Any additional you can provide:
7
*This Clearance will only be 4alid 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 at 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 ac e to the best o w e ge. have read e conditions o approval„ � d I understand them and that I will abide by them.
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Signature Printed � (A v
gn
APPROVAL INFORMATION
[� ] Approved as proposed [1I/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 �sit,�e c,,oym�p�lies i th Vlan as o this date.
Notes: S� Q, a ze/
Building Official Date
Zoning Official Date t7JA 101
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