HomeMy WebLinkAboutCLE201000054 Review Comments Zoning Clearance 2010-03-29County otAlbemarle liepartment or %_ommumty Leveiopment
401 McIntire Road Charlottesville, VA 22902-ro-rice:-(434) 296 -5832 Fax: (434) 972 -4126
Revised 04/28/08, 10/13/09 Page 2 of 3
� _Zoning Clearance = $35
OFFICE USE ONL
Check # r�. S Date:
PLEASE REVIEW ALL 3 SHEETS
Receipt # Staff:
PARCEL INFORMATION
Tax Map and Parcel: o(o I \140 r- ®3— C�(')� C� 2i iq® Existing Zoning 676Inme -re7y AL.i
-P-a ce -Owwer:
Parcel Address:�(� u..lmaVio -a City a1`IC6&S i State Zip 12-1dI
(include suite or floor)
PRIMARY CONTACT
(� ck_ l k`e-�s
- .Who should we call /write concerning this_project? yf ex
Address : cs l NV i I i ram --qm RA City 1 0a a4C� State Zip
SirQ _ S"�jA
Office Phone: (S o) (o(o- t 7 Q Cell # 537 7-`10 1 Fax # 7Z E- mail er C� I11 �C/zl� 1�GE3 e h1
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name K New business
Business Name/Type: I Ci S�� (o 1-- f-�-
r�,,
Previous Business on this site r I QN 4� L(7-(;S
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
vehicles, and any additiona hat you can provide: 2 C' M 0I FW FPS I S:W1 park, � Z 1 1,e,Ki de.S
1
*This Clearance will only id on e 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 I own have the owner's to se the space indicated on this application. I also certify that the information provided
6pes'--sion
is true and accurate o est of my wledv ead the conditions of approva4441A I understand them, and that I will abide by them.
Si nature Printed lC K
g _
tiA,P,,�ROVAL INFORMATION
[ ] Denied
[ Approved as proposed [ Approved with conditions
[ ] 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 w th the ite plan as of this date.
Notes: IrC 5 ��U�
Building Official r Date I Lb t
Zoning Official Date
Other Official Date
County otAlbemarle liepartment or %_ommumty Leveiopment
401 McIntire Road Charlottesville, VA 22902-ro-rice:-(434) 296 -5832 Fax: (434) 972 -4126
Revised 04/28/08, 10/13/09 Page 2 of 3