HomeMy WebLinkAboutCLE201000041 Review Comments Zoning Clearance 2010-04-08A TicatiCL for Zo to Clearance
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OFFICE U Y
Zoning Clearance ° $35
Check # Date: A-11-1.6
PLEASE REVIEW ALL 3 SHEETS
Receipt # Staff- a
PARCEL INFORMATION
Tax Map and Parcel: 61 - -d Existing Zoning W,
- Parcel Owner-:- - -
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Parcel Address: City WO'lle State Zip
(include suite or floor)
PRIMARY_CONTACT
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Who should we call/write concerning this project
Address : �F 2� "1..� RAJ- kJ 5�' City _I A6" " State zip� b
Office Phone: ( 6 3 -f ell # Fax # E -mail
APPLICANT INFORMATION
Check any that apply:. Change of ownership Change of use Change of name New business
Business Name /Type: LA5 ,)Mai �g�'a�,�Tp (�Ct�YL JYIQ A,
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:
*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 owner's permi sion to use the space indicated on this application. I also certify that the information provided
is true and accurate to th est o y knowledge 1 ave read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed.
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APPROVA INFORMATION
[ ,,Approved 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 Jhe��jjsite plan as of this date.
Notes:_2 /(7 -M) C2
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Building Officials Date ( \�
Zoning Official a _ Date s o
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