HomeMy WebLinkAboutCLE201000039 Review Comments Zoning Clearance 2010-03-11= Clearan
Application for Zoning ce=
- - - -- ❑Zoning Clearance-= $35 - -- - -- -
OFFICE USE Y
Check # -- Date: 3;q- L6
PLEASE REVIEW ALL 3 SHEETS
Receipt # Staff: A r
PARCEL INFORMATION
Tax Map and Parcel: t1% 00 03 — ®J 2 .6-0 Existing Zoning
Parcel Owner : - J__ _- _ n
_ - -_ _ _ cao_
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Parcel Address: 30S2_ t"j !�- 'ty C b State V`'1 Zip
(include suite or floor)
.PRIMARY CONTACT
-Who should we call7Write c_onc_erningthis project?
Address : City State Zip
Office Phone: Cell # Fax # E -mail
APPLICANT INFORMATION
New business
Check any that apply: Change of ownership Change of use Change of name,,
� �n
Business Name /Type:
Previous Business this ch A e-e
on site
Describe the proposed business including use, number of employees. number of shifts, available p rking spacgs' number�,°f
�, i i 61
v icles, an an additional, information that you ca provide: , ,' i 6
"� h can - r-; l
\lam I t pu- v �.
*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 _ LNAe�&� Printed
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APP OVAL INFORMATION
proved as proposed [ ] Approved with conditions [ ] Denied
[ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, x117.
[ ] 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 theysite plan as of this date.
Notes:
Building Officialk� Date ` ii
Zoning Official Date C� lC
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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