HomeMy WebLinkAboutCLE200900143 Review Comments Zoning Clearance 2009-09-24Application for ®fin. n g_Clearance
_ _- _Z
Zoning Clearance — $35
OFFICE USE ONLY
Check # 5_Q 1, 'Vq- Date:
PLEAS REVIEW ALL 3 SHEETS
Receipt # T70 r Staff:
PARCEL INFORMATION,^ j
o �/
Tax Map Parcel:
and u�U� Existing Zoning_/
-Ra-r- Eel- Ovvner: -- -
` /
Parcel Address: ��D�o�2b L.1�I\I� City C{4AVz,1_076SV(LLEState y Zip22g63
(include suite or floor)
PRIMARY CONTACT _
Who should we call/write concerning this project? ] cir>y
l5C6V city i� lC--1 AoN� State Zi 322°1
Address : �{ -D��VF Ci p2
Office Phone: (�) 7$ 7- I t { `% Cell #APB- Fax # log -757- M-5 E -mail -1-� ra ► E6 b avid +Ca
801 -335 - $70(0
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name =New business
Business Name /Type:�e4N
Previous Business on this site s-A
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: 13WK hL_4l
*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 know dge. I have read the conditions of approval, and I understand them,, and that I will abide by them.
_. Signature / Printed -
AP OVAL 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 hysical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing
smte an.
This site com lies with the site plan as o�thi`jdate.
Notes: ' -JgS �' -jI o91 6 L 14 b
a
Building Official Date
Zoning Official
Date N
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