HomeMy WebLinkAboutCLE200900119 Review Comments No Submittal Type Selected 2009-08-10application for Zo _Clearance _ ---_
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Zoning Clearance =.$35
PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ON'6
Check # (Q,`i Date:
Receipt # -7 5 i F `7 Staff: � lI
PARCEL INFORMA-�QN `
Tax Map and Parcel: 66 � �J Existing ZoninLy (,�Q Vt �✓
- Parcel- Owner:— - _ _
ParcelAddress: Z J�� COMM (i /�t Ty C r i/�Z - State V� Zi?-
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project?
Address :2, � � , -(J" ��ity State t/� Zip �'2Z
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Office Phone: cell # Q`Fy ^ Fax#��- " E -mail Al
APPLICANT INFORMATION
Check any that apply: Change Change of use Change of name New business
�of�ownership
�
Business Name /Type: 1 ! G. v �v /V c
Previous Business on this site
Describe the proposed business including use, number of employees, n tuber of shifts, available arking spaces, number of
vehicles, and any additional information that you can provide: - b
*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 own o ave t owner's permission to use the space indicated on this application. I also certify that the information provided
is true and orate to the e of owledge. I have read the conditions of approval, and I{understand them, and that I will /abide by them.
- Signature _ _ - Printed
APPWVAL INFORMATION
[ pproved as proposed [ ] Approved with conditions [ ] Denied
PP
[ ] 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 tie si�anjas of this date.
Notes:
v
Building Official Date
Zoning Official Date g )�
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
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