HomeMy WebLinkAboutCLE200900155 Review Comments Zoning Clearance 2009-10-06_A licatioll Zon n Clearance
CLE #,
Zoning Clearance = $35
OFFICE USE ONLY r2�
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Check # Date: 7
PLEAKIt REVIEW ALL 3 SHEETS
Receipt # - - Staff: r
PARCEL INFORMATION = - — - -- —
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Tax Map and Parcel: l t� Existing Zoning_i�
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- ar- cekOwner -:= ' — t
Parcel Address: City State Zip
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project?
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Address : - �"+g _ W City 7OALZ__ State i r 0' q Zip
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Office Phone: C Cell # Fax # E -mail
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
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V40-P-05
Business Name /Type: s4 , r)
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: ltw_ 0
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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 regAed.
I hereby certify tha I or ha the er's permission to use the space indicated on this application. I also certify that the information provided
is true and accurate the best o y o ledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature t - Printed _ -_- _ —C ir'✓t —
ig
AP %OVAL INFORMA ION r.
[_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
Zoning Official Date pl
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