HomeMy WebLinkAboutCLE200900194 Review Comments Zoning Clearance 2009-12-01Applictosrfor
-
Zoning Clearance = $35
OFFICE USE ONLY
Check # Date:
- --PLEASE REVIEW ALL 3 SHEETS - - --
Receipt _q� Staff: 1n�->
PARCEL INFORMATION
Tax Map and Parcel: 00 CC _ tic — is — Existing Zoning
-p' arcel OWITe
Parcel Address: �•��+ -c City C' t-i a : PLC e State j ,1' Zip
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? IE K:7 WA cs1C &!
Address: 320- RLk City C. i+ k u' C t: i State VA- Zip TLA i 1
Office Phone: (!( b AL — 5'9 -' f Cell # C, S'cC_ Fax # E -mail Rcw
A C =3tvh �rtii Z'
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name /Type: i3c, -1 kc,'�S ,= �ln acvi i �L ✓�.a� i:.'c,L , L
Previous Business on this site
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: f-" � `°� s Li wi=r %A-j
*This 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 knowledge. I have read the conditions of approval,+ and I understand them, and that I will abide by them.
Signature Printed Al .4- L, 7_rf YL -r- - - --
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, x14.9: 11
[ ] 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 ((I 3> g °
Zoning Official F' Date %/ // /1
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