HomeMy WebLinkAboutCLE201000019 Review Comments Zoning Clearance 2010-02-23- - COMMHN- I- W= DEVELOPMFNT4- E- a-x -d3d9- 7=241 -26 Feb 11 - -2-pU 10:01am P_003 /00d
,Application for Zoningiearaxce
ed
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OFFICE USE
.Zoning Clearance =S35 __— -__ -_ _ -
Check #_ A_ate:_
-- _
Receipt # Staff:
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)?LEASE REVIEW ALL 3 SHEETS
PARCEL INFORMATION
Tax Map and I' reel: � (� 4'S Existiu�g Zoning
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Parcel Owner: _ @ r L
(*� f
Q,3� ��}O� zxp
���' Cttv L J� i State
Farcel ,A.ddressc
(include sui or floor)
PRIM- ARX CONTACT -
- _ho. should we_call/_write_-Conceir_niAg this P:roject?_
p V
�� State ziAddress
Office Fhotte: 19"6 -T Cell #ltd fax #��"C'�r7 E- mail 1,
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APPLICANT INFORMATION'
Check, any that apply- Change of ownership Change of use Change of name 3ew4ymjlms
Business NamelType:
1
Previous Business ou tlta6 site {
Describe the proposed business including use, number of emplo ees, numbe Of shifts, available a�spaacces, nu bier of CI
vehicles, and any additional info mati n that you can provide:
4
*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 owners percussion to use the space indicated on this application I also certify that the information provided
is true and�ecurate to the best of my laoowledge. I have read the conditions of approval, and I Understand them, and that I will+�abide by theta.
e
Yzitlted �91 1N e
Signs
AP OVAI.INFORMATION
Approved as proposed [ ] Approved with conditions [ ] Denied
[ ) Backflow prevention device and/or current test data needed for this site. Contact,A,CSA, 977 -4511, x117,
[ ] No physical site inspection has been done for this clearance. Thm4ore, it is not a detenriination of compliance with the existing
site plan.
[ ] This site complies with the site Ian s of this date.
Notes:
Building Official - pate [� f
Zoning Official Date
Other Official Date
l.ounty OI A1Demarle AJeparG,lJaeAL VA <. VAAAAAA4 MAAJ' Nc� AVFAAA-M1
4 I McIntire )(toad Cbarlattesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4£26
Revised 04 /28/08, 10/13/09 Page 2 of 3