HomeMy WebLinkAboutCLE201000060 Review Comments Zoning Clearance 2010-04-16Application for Zoning Clearance-
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Clearance = $35'7 _ __
Check # Date:
PLEASE REVIEW ALL 3 SHEETS
Receipt # Staff:
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PARCEL
Tax Ma an d 'M
ft Existing Zoning
Parcel Owner -• --
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Parcel Address: ) y UDY City l State Zip
(include suite or floor)
PRIMARY CONTACT
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Who should we call /write concerning this project. r
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Address:
Of Phone: ' 165-01Y Cell # g3g7A5-01�ax # E -mail c -e C060; IV
APPLICANT INFO ION
Check any that apply: of ownership Change of use Change of name New business
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Business Name /Type: l O bq, )4 4p � i I L C /r✓P
Previous Business on this site '
Describe the proposed business including use, number of employees,, number of shifts, available parking s aces, number of
vehicles, and any additional information that you can provide: C) C� SLe- C�'$41 0 V1 e- L�n1fo 6 0 n
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*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 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.
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Signature C Printed V0
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APP OVAL INFORMATION
[,.'Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Baclflow 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
r
Zoning Official Date
Other Official 1 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