HomeMy WebLinkAboutCLE200900132 Review Comments Zoning Clearance 2009-08-24- fi� t
Application for " Zoning Clearance__
CLE - G __
Zoning Clearance = $35
PLEA REVIEW ALL 3 SHEETS
OFFICE USE ONLY p
Check # Date: (� `d -
Receipt # i -- 713 13 Staff- d
PARCEL INFORMATION Z �7 -
Tax Map and Parcel: /?1- 3 f �� Existing Zoning
- P- ar -cel- Owner -:
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Parcel Address: ,-7 a 11)4m i vd ��C� City State � -• Zipl�'CJ`��
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? iJ; e_n - --R( anci, - -
Address :.3LK c'7 Se.s� �,,%�� ���c _I��City �'j�J - State 4% A-- Zip ZZI
Office Phone: tf-3 47/ �9 Y� Cell #, ie e "tL(7� ZZOax # 4t` ?ci 97% `,e46E -mail
APPLICANT INFORM,�VTION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name /Type: ►� /�Q i S
Previous Business on this site
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:
*This Clearance will only be valid on the parcel for which it is approved. If you change, intensify or move the use to anew location, anew 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. V-
APPROVAL INFORMATION v
"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 Z�o (Oc�
Zoning Official Date V Ab
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