HomeMy WebLinkAboutCLE200900157 Review Comments No Submittal Type Selected 2009-10-08PPI
lcation for Zooming Clearance
-�- -_
CLE# - - --
OFFICE USE ONLY
Zoning Clearance= $35 Check #
Receipt #
PLEAS REVIEW ALL 3 SHEETS P
PARCEL INFORMATION > Existin Zonin
Tax Map and Parcel: 0 r(i �"'� f g
Date ' g- ro/
Staff:
Ms
-- - -- Parcel- Owner: - - - -- - - 411- - 2-4 20
Parcel Address:_ l
3 U ���Qf JA City L `� - State Zip
(include suite or floor)201 -f w
PRIMARY CONTACT lc
Who should we call /write concerning this projects c /I,- 7 / Coin- moo c,)e � � City r—Arl,, (0 `% 9 4'11j_ State Zip a
Address : ��� 3 � l� — ,r `— r
Office Phone:
( ) Cell #500 -S69-(08 Fax #F(66 - 900- 141f!'jE -mail
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name /Type: in S r { in '� - h c G B/ ► 1/,'e
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: Sd0-W y a +�� m -�� Pin—`" � sh' `
aj. 6 ej a
*This Clearance will only be valid on the parcel for which it is approved. If you change, intensify or move the use io a new Imi ivu, ..'5
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
APP/20VAL INFORMATION Denied
[ Approved as proposed [ ] Approved with conditions [ ]
[ ] 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.
Building Official Date [ �-
Zoning Official
Date 1 p $
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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