HomeMy WebLinkAboutCLE200900106 Review Comments No Submittal Type Selected 2009-07-15_-- Application for Zoning_ Clearance
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Zoning Clearance = $35
PLEAS& REVIEW ALL 3 SHEETS
OFFICE USE ONLY ?
Check # Date: 0 - - - - --
Receipt # —7 6zj q7_ Staff: d DILL �
PARCEL INFORMATION r�
Tax Ma and Parcel: /� Existing Zoningaulwti.�wc�. I ��
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Parcel Address: T3IUe G o5e -lI& z&'City" r 7_eJr State
(include suite or floor)
PRIMARY CONTACT r
Who should we call /write concerning this project?
Address: Just 3 ci Cn 1 � P � � City C r r) z_Q - State V a Zip 3Z
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Office Phone: L_) Cell # T� '� 1 � - Fax # E -mail 444 of fj !� 1E 7�4 C4f T
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APPLICANT INFORMATION
Ch ck any that apply: Change of ownership Change of use Change of name - -flew business
Business Name /Type: MOLSSci_y y 1 kzV-C�_ P!
Previous Business on this site i V\.S V V 0.rC-e wC�ti �eS! q�t C 2�U1 -t S E�i ln.�
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
vehicles, and any additional informationL that you can provide: is _P1 v
ko O U1"n i� OT(lG2S *IV, 6uf1 � 1�- 'tV
*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 will abide by them.
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Signature 6,- r Q Printed U ax4
APKOVAL INFORMATION
Vf Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Baclflow 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 '
Zoning Official Date G`d
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