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HomeMy WebLinkAboutCLE200900195 Review Comments Zoning Clearance 2009-12-01A _ -licat on -_for _Z ®nin = C- 1_earan-a _ - Zoning Clearance = $35 OFFICE USE ONLY Check # `. 4 Date: [moo - - -- -PLEASE REVIEW ALL`3- SHEETS - - Receipt #- - k9q& _ Staff: y PARCEL INFORMATION " '7 Tax Map and Parcel: 07,F 00— 0 0— Q 0 -- O 1 b 0 Existing Zoning = P- ar -cel- Owner: - Parcel Address: 3q �( ' Zdp s' CTS City Cf+Aoe_q)Z7 V-RJ,U P,_ State VA- Zip 2210 � (include suite or floor) PRIMARY CONTACT Who should we call /write concerning this project? �d L�� GJ'A Z- CA -' Address..520LdL City Cis acts State VA- Zip ;Lt34 p Office Phone: (34 ) Z R qC n 5131 Cell # ITgo6 Fax # E -mail UA L-rliA-1 6 AC6j� � ` CAI APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business G -cBusiness Name /Type: 66 Y fCOIA z S 0(m hy'Ll C O SL_,/. e(� LC J"Xcf + � - 44A 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: �C -.`"+2 C %k (L *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 t9vje best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. /, Signature Printed d9 C Tc �.f . _ APPROVAL INFORMATION 1 Approved as proposed [ ] Approved with conditions [ ] Denied ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, x+1-9 -11 4- [ ] 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 (k ( ,a Zoning Official Date %'L�Of 0 Y 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