HomeMy WebLinkAboutCLE200900174 Review Comments Zoning Clearance 2009-10-15Application for Zoning_ Clearance
CLE
Zoning Clearance = $35
OFFICE USE ONLY
Check # 2 %2 Date:
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- -- PLEA -REVI HW ALL 3 SHEETS - --
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Receipt# -� -- fD - Staff: r
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PARCEL INFORMATION/�
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Tax Map and Parcel: ^Q(i Existing Zoning
Parcel-Owne
Parcel Address: J 1� City (/lifd Zf _ State / Zip
(include suite or floor)
PRIMARY CONTACT �/ .
Who should we call/write concerning this project? �� d� U_ 4,6rh � %V
Address : 3�s ` 7 �YLtLD►'1 f, C_ / City {�G� State 6� Zip
Office Phone: C 823`Vy J Cell # �`�� Fax #M- 7620
�E-mail
APPLICANT INFORMATION
Check any that apply: Change of ownership _Y,_ Change of use Change of name New business
Business Name/Type: �-� 11:�� -�t- 4 %7�t
Previous Business on this site
Describe the proposed business including use, number of employees, number of s ifts, a ilable parking s a es, umber of
vehicles, and any additional information that you can provide: l�G r4
*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 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.
- - _ _ _..Printed 64 INCiyt_ _ ' IC4-
Signature / ®2. --- XCW
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APPROVAL INFORMATION
[ Approved as proposed [ ] Approved with conditions [ ] Denied
[X Approved
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 j-,=�
Zoning Official — - `�`-, Date�'e�f=
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