HomeMy WebLinkAboutCLE200900133 Review Comments Zoning Clearance 2009-08-19Application for Zoning Clearance- __ -_ -__
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Zoning Clearance _ $35
OFFICE USE LY
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Check # 0 0 � Date:
PLEA'S51 REVIEW ALL 3 SHEETS
Receipt # Staff: d tL ej
PARCEL INFORMATION —
Tax Map and Parcel: Existing Zoning_ �s
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Parcel Address: '� 53 D Mr) n aca 6T i � �� . City �nY� C�tQM er7 State y � Zip �"��
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? I)= -5wc son
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Address: -s S o �, city C o ye5 y, I ( e State V A Zip aa93 f
Office Phone: (D$ - ��Y� Cell # 9 LOQ - %73 L Fax # E -mail
APPLICANT INFORMATION
Check any that apply: _ %L Change of ownership Change of use Change of name New business
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Business Name /Type: Q LA � l S � r oce r V l 1. D A V t° 111,- Y1 C E
Previous Business on this site— C me Q5 cAbo VE
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: EM JO yee S - 0 -3�%M 5 ---
*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 5 ` 1 L' j' t We-t-r e—s
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, 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 the site plan as of this date.
Notes:
Building Official Date t .%
Zoning Official Date
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