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HomeMy WebLinkAboutCLE200900173 Review Comments Zoning Clearance 2009-10-12_Ap_plic_aton for Zoning = Clearance - -- ❑ Zoning Clearance = $35 - -- - OFFICE MNLY Check # Date: - Receipt # - " ' - Staff: PLEASE REVIEW ALL 3 SHEETS- PARCEL INFORMATIO Tax Map and Parcel: 0% © Q� ] �� �% Existing Zoning L Parcel Owner���- 'C �— Parcel Address: y J J -- f3 C • City '-1 �� �5 i *te Zip ip�0J (include suite or floor) PRIMARY CONTACT 1 Who should we call /write concerning this project? Z1P Y Address: "Y . i( State Office Phone: aq 6-�5g 5Cell # ,:5 3) V03 Fax #d °7& - )I E -mail 111�1 -e _ e- a APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business Name /Type: 4 n i 1� �a" ""4.e. o Previous Business this site -Ti *,t iU on 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:x LAStin , ri !' )n Cc &/I ^-f *This Clearance will only be valid on the parcel for whic it i approved. If yoh change-in te sift' or move the use fo a new location, a new Zoning Clearance will be required. I hereby certify that I own or have the owner's pemipsion to use the space indicated on this application. I also certify that the information provided is true and accurate the best of my knowledge. Piave read the conditions of approval, and I understand them"that abide by them. t' Printed - - - Sib ature _ - - APPROVAL INFORMATION Approved as proposed [/j 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. E�PC �� Y �!??, / l o (� Aj 'Z'A1 Y J/6 1 ,a [ ] This site complies with the site plan as of this date. (j Notes: - e Building Official Date (of I )Caa Zoning Official _ ', �`� Date Other Official Date uounly oY A1Demarle Lepal-MeHL 01 k- WHIuuuuy LUV V1VFuuuL 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 Revised 04/28/08 Page 2 of 3