HomeMy WebLinkAboutCLE200900163 Review Comments Zoning Clearance 2009-10-08A�lrcation foron Clearance
CLE ID 3
L/ Zoning Clearance = $35
ONLY
Check # Date: ` U
PLEASE REVIEW ALL 3 SHEETS
,�� c
Receipt # M .5(e � Staff: (W
PARCEL INFORMATION
Tax Map and Parcel: io 61— ice` 0 �60 — 6 02 0 O Pe -tc-d R Existing Zoning
Parcel Owner: /42o -14X y- p4c.2 LG-C c/o A" Z�rry e-ty
-Pa- reel- Addr- Address: - - -_14. State f%/-)- Zip 2.?yiof
(include suite or floor)
PRIMARY CONTACT ->
Who should we call/write concerning this project?
Address : `� : ' C d �' 6'! �'; City �c i" i C �C =t-y'i °State Lf Zap
Office Phone: (`33- 773 SZ' Cell# `� 167'1 Fax L- 34 Y73 E -mail .9 Gceyin��NSGei3
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
r
Business Name /Type: `-�
� °�`'' �Jce�� E <.!6_ j � / � � _ +)
Previous Business on this site ¢ CC 6 1 j i.1 �A- uurx
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: r,, a irrj�� !L q , 2 ftt&
V
2 C I�CF� S a - pw'i`C UQ< 14 iUam" S 44,
a rA
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.
1 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 b st of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed
/ i
A,,90ROVAIC INFORMATION
[ ] Approved as proposed [ kfA*pproved with conditions [ ] Denied
[ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, xl 19.
[ ] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing
site plan.
[ ] This s' omplies with the sit plan as of this date.
Notes:
Building Official �— Date (0 �Z,(
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