HomeMy WebLinkAboutCLE200900142 Review Comments Zoning Clearance 2009-09-04Application for Zoni4 Clearance
Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
OFFICE USE Yry�Q
Check # Date:
Receipt # % ' i Staff: J rl
PARCEL INFORMATION /� r j / �j —
Tax Map and Parcel: l `/ I Existing Zoning / ��
Parcel- Own=er:= - (�`I'�'� ���Ii�7� � ��►Ff -� - -t � " = _ � ,
Parcel Address h 00 � � � � ' City �, ► I t � � � � State Zip
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? A,4 ✓ G UlJ
Address: /?9 Z_ City C& At r7�si/lLfi�te v'/1 Zip 2 7_9o/
Office Phone: Y3y �'I73 -5 d Cell Y� I7- �Fax # E -mail kqy kv7 ee Y1w,41L. Goy
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name t% New business
Business Name /Type: .'z-
Previous Business on this site r 7 z
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: Ae -' 55 o-/a j
*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 bav)- the o me ' ssion to use the space indicated on this application. I also certify that the information provided
is true and accurate t . _b, best my,.knowle . I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed-
APP R6VAL 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 >A 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