HomeMy WebLinkAboutCLE200900209 Review Comments Zoning Clearance 2009-12-09i
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Application for Zoning C
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- -- - Zoning Clearance = $35 -
OFFICE USE ONLY
Check # xa 7� - - Date:
PLEASE REVIEW ALL 3 SHEETS
Receipt # ZG%,P r Staff.
PARCEL INFORMATION
Tax Map and Parcel: c7 e; % yo — o ®- 0 8 —joy 6 0 Existing Zoning Al"V oO
- Parcel
hl Parcel Address: City L� �i�� Ile- State J�e9 Zip
(include suiYeo o
PRIMARY CONTACT /A 1
-Who �'
ould we calUwiite concermng_ths project
Address :�ie/ LG d� i%a l ( f "I� City j � V'4! State I zip 7Z�(
Office Phone: L� Cell #> d -C 3 ef`� Fax # E- mai1`jctr�ys y72Yj�� '��
APPLICANT INFORMATION
Change of ownership Change of use Change of name New business
Check any that appl��y:
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Business Name /Type, D
Previous Business on this site
Describe the proposed business including use, number of employees, number of shifts, available par Rg spaces, number of
vehicles, and any additional information that you can provide:_- _9�r�%Izz.'�r C / %//l f' G%✓� .;c
*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,l own or have the owner's pennission to use the space indicated on this application. I also certify that the information provided
is true and accurate to �he best of my kno�whedge. I have read the conditions of approval, and I understand them, and that I will abide by them.
i �d�li� Printed /,I d;,� !'r '1
Signature , ,�P {,. c .
a,
A OVAL INFORMAT.JION
[ ] Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] B kflow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, x117.
[ 1 o 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 04/28/08, 10/13/09 Page 2 of 3
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