HomeMy WebLinkAboutCLE201000049 Review Comments Zoning Clearance 2010-03-19Application for Zonn - Clearance
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-- -- - - - - -- CLE #/�5
- q Zoning Clearance = $35 -
OFFICE USE ONLY a� w
Check # Date:
PLEASE REVIEW ALL 3 SHEETS
Receipt # " 5 Staff.
PARCEL INFORMATION
2-Z
Tax Map and Parcel: ` Existing Zoning
Parcel Owner:----�iT�1
Parcel Address: qtQ -7 �� r�City �� State VA Zi —is l o
(include suite or floor)
PRIMARY CONTACT
-��il� ��t�
mho should w- e�l7write concerning this project?
Address :e4167 3 —Acca. EL City ra vG%-� State \i' Zip2`1-S-50
Office Phone: Z57)-765--65z)9- Cell # Fax # E -mail ( t tiC�ii�Y6i c5�S�
APPLICANT INFORMATION
Check any that apply: Change of ownership of use Change of name ?� New business
iChange
Business Name /Type: �• � �7ii� 'lnL� �.� i��Z7d�sS tom- ;' 9P &L'o'w J)w -& `aE -6fe .) r"
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 provider
*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 wner's permission to use the space indicated on this application. I also certify that the information provided
is true and accurate to cnowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed
APP,R6V AL 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 the site plan as of this date.
Notes:
Building Official Date
Zoning Official ZATA7r Date � L � I 10
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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