HomeMy WebLinkAboutCLE200900120 Review Comments Zoning Clearance 2009-08-21Applicatom fo Z.onn_ Clearance
Zoning Clearance = $35
OFFICE USE ONLY
Check # 1i' � 1 Date: � � 1 ✓ � ` - --
Receipt # Staff: j /411
PLEAS REVIEW ALL 3 SHEETS
PARCEL INFORMATIO
Tax Map and Parcel: " (A4 - f-v Existing Zoning
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-Pa-rcelOwner: � — -
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Parcel Address: , ,!
(include suite or floor)
�MARY CONTACT p ,q
-hoshould we call/write concerning this project? c ► oy(' j
Address: sad 5a ��e}iil� 4b City tate � R • Zip
Office Phone: q{%s4 6j Cell # /gNP69 /gi0Fax # E -mail
APPLICANT INFORMATION
Check any that apply: = Change of ownershi Change of use Change of name New business
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Previous Business on this site
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
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vehicles, and any. additional information that you can provide: 1
*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 y knowle ae. I have read the conditions of approval, and I understand them, and that I will abide by them.
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Signature Printed `� - - -� 16" LJ -- - —
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APPROVAf 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 st�omplies with the site plan as of this date.
Notes:
Building Official Date
Zoning Official Date
Other Official Date
County of Albemarle Department of Community JJeveiopment
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 04/28/08 Page 2 of 3