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HomeMy WebLinkAboutCLE200900136 Review Comments Zoning Clearance 2009-09-01Application for Zoni Clearance
CLE # _.-
XZoning Clearance =S35 -
OFFICE USE O Y
Check # Date: C) f "I
U _e ' Staff: J U;TW
PLRA REVIEW ALL 3 SHEETS
Receipt #
PARCEL INFORMATION - j - - -_ -
Tax Map and Parcel: J Existing Zoning
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a✓ ''l �� ty L� "' � %�T I`sS& e VIT Zip z)--2_!?°
Parcel Address: ® � 0 Ci
(include suite or floor)
PRIMARY CONTACT _
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Who should we call/write concerning this project?
- - -- -- ------ - - - - -- - - -- -
Address 6lu 6T �l City State y/f - Zip�Ro I ocl
3 W5-- 5-b/C Cell # 7.? 4Z5- -)-V %iFax # E -mail
Office Phone: ( o
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name/Type: N7C: p� R L S C= �G° A`� KTAI PA 7C ft
Previous Business on this site -17011 I--% r
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: b
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*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, - - -- - 's - Printed YO 5� &-f- /-I(-- /f �✓i e -
OVA 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 �n Mp4es with the site plan as of this date. `�,
Notes: � t't o C,�2 AV, !r�- gjLI , {'+�tu/�I G�Ltti� l "6`Q� � C S +M y q,,'—
Building Official Date I_ X
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
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