HomeMy WebLinkAboutCLE200900182 Review Comments Zoning Clearance 2009-10-22Application for Zom Clearance -_ - - - - - -_'
m
koningCle,arance=$35,
OFFICE USE NLY
Check # Date:
J
PLEASE REVIEW ALL 3 SHEETS
Receipt # Staff:
- --
PARCEL INFORMATION
Tax Map and Parcel- 0 7 ;FO0 --•00 - 60 ' Fla Existing Zoning_ /
a C tlwn � Y 1��
Parcel Address: 6 3e) Pe City 1 gym, %o J1e5V Jle State J Zip
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project?
Address:. lid t7 p p '�Q[. ;Y�,ct ?a ,ii9f�,#A ., S1A [fib City 0' ,19fi)() .�-}t' 1 State 1� .� Zip 2Z II
Office Phone: C W - Z5S5 CeII # _ Fax # (, �� E-mail j�yl[Ip(�1ii �i' Q S C.
�
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use ViChange of name New business
Business Name/ Type: 0 Slum A I Yg1n. KA ()'1m -6 'M Id iell Ce..?
Previous Business on this site M
Aazw i C64
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
� .q 15 .n a -
vehicles,. and any additional information that you can. provide: �1
Y.
: ,. -
00 ,m. (%( aia Wl r
4
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 Pe best of losowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
_Signature- - - - Printed.- _ - - a- i" - -
AP VAL INFORMATION r
[ Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Backflow 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
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 04/28108, 10113/09 Page 2 of 3
xdivl