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HomeMy WebLinkAboutCLE200900135 Review Comments Zoning Clearance 2009-09-11pplcatonf_oT.Z ®-An2- Clea-ran_ce- _ © Zoning Clearance = $35 OFFICE USE ONLY i G Check 4 79 5 Date: 7 - - PLEASE- REVIEW ALL 3 SHEETS Recei t # —7 c Staff: f p� PARCEL INFORMATION Tax Map and Parcel: Existing Zoning/ 1 6 -i r 1 4,,' 6-­Z� . -sL. CY gf� ( "i `''� City (� 1�1� �= State V� Zip s i Parcel Address: A %f �ia (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project' -: Cl� - G Z�G; "�. � (Vi '` Address :.ice -� fi� t l� � �� � State Zip OL E l Office Phone: Cell , ] Fax # -mail APPLICANT INFORMATION n Check any that apply: Change of ownership Change of use Change of name New business Business Name /Type: ja/ PO— A '>;? Z) v--- --p Previous Business on this site lam] sr'� p" 'i� L W �t , e , 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: � _ y\ 1 S " *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 pe 'ssion to use the space indicated on this application. I also certify that the information provided is true and accurate to the of knowle e. ave read the conditions of approval, and I understand them, and that I will abide by them. n Signature // Printed 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 com li with the sitF plan as of this date. Notes: yU Building Official Date ��� 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