HomeMy WebLinkAboutCLE200900177 Review Comments Zoning Clearance 2009-10-22(4�14
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Application f or Z- m _____ - -- -
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PLEASZonin g Clearance - $35
REVIEW ALL 3 SHEETS
OFFICE USE O Y_
Check # / rbc1 Date.
Receipt # (It 7 Z S Staff: 04
PARCEL INFORMATION' --
Tag Map and Parcel: -19 7 FOO 00 _00 —031 e (r) Existing Zoningi� -- - --
1 -
Parcel Address: TS �r ¢er 11 City /Ao W�&State ?,4 -- Zip ZZ 1
(include suite r fl r) 2
PRIMARY CONTACT
Who should we call/write concerning this project? Y i VA / -
Address: 2 L City �' date \ f"C Zip 1 to
Office Phone: (45 4LA U—' Cell # DS J -toff F''ax # C&2- E-mail t L( • V C i
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APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
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Business Name/Type: `::C3'1J, )( T C
Previous Business on this site
Describe the proposed business including use, number of employees, number of shifts, avail ble parking spaces, number of
ve icles, and any additional information that you can provide: gjay� r, a uu 5s dIp
*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.
_Signature _ Printed-
APYAOVAL INFORMATION
[ Approved as proposed [ j Approved with conditions [ ]Denied
[ ] Bacltflow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, x117.
[ ] 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 o
/
Zoning Official Date
Other Official Date
County of Albemarle Department of c:ommumty veveiopment
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 04128108,10/13109 Page 2 of 3