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HomeMy WebLinkAboutCLE200900191 Review Comments Zoning Clearance 2009-11-02Application for Zonin Clearance- - CLE # _ -' Zonin Clearance = $35 OFFICE USE NLY Check #_- __,_Date:_ /0 (/ /.� `0 PLEASE REVIEW ALL 3 SHEETS Receipt # I& b9E Staff: d it, . PARCEL INFORMATION r I - 5 C Tax Map and Parcel: Existing Zoning U = Parc el- Owner - :- 5- )/-'f'i'- -�r✓SJ Parcel Address: City C 0,41, C® T76-S State - Zips 9 (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? �j ®SCE �{{ ^/I ff(. GA SW Address.: lf! Cab zw " � r- % City M/ N/ S State r Office Phone: (}L3) Cell# Fax# E -mail Yek5 Pi4_lq I @MSN °Cz t APPLICANT INFORMATION Check any that apply: Change of ownership hanJge of use 'range of name New business Business Name /Type: �= g . E-Al 7 U� ge �a 5 E > C )I x i5 Tm e S � Previous Business on this site �i¢ ,5_YY7a /U h,411 �'.� OF k-S A) C L UT 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: 7P. FE SA-CO-5 s 3 C i°1 PCc ` 6U S . S y ��, 1t %% 1u C- 4-o T D P *Thus Clearance will only be valid on the parcel for which it is approved. If you change, intensify or move the use to anew location, anew 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 lrnowledge. I ave read the conditions of approval, and I understand them, and that I will abide by them. Signature _ _ __.___ _ ___ __ -- - - -- _ _ _ Printed.___ c/ E P ��' . LAS -M eL1J _7 1S 1- APPROVAL INFORMATION ' [ ] Approved as proposed [ ] 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. [ ] This site complies with the site plan as of this date. Notes: Building Official Date Zoning Official Date Other Official ` N i Date %/ 143 /©F 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