HomeMy WebLinkAboutCLE201000063 Review Comments Zoning Clearance 2010-04-16a — _
Application for Zoning - Clearance
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CL-E#---
-- - -- - Z-oning- Clearance = $35`- -- - -
OFFICE USE ONLY G -
Check # -- — 5,3 q 0 Date:
LIB%
PLI REVIEW ALL 3 SHEETS
Receipt # Staff:
PARCEL INFORMATION 76 �j �`
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Tax Map and Parcel: C Existing Zoning li
Parcel. Owner:__- _ - - ----- -- - - - - -- —
� E Gr,
Parcel Address: City 'U State Zip��
(include suite or floo
PRIMARY CONTACT`
— — _ - -�- -� -� — ��_-
Who s iouZd we callTwrite concerning this project?
Addrrp`h�n � City -( ��� -- State - ZipO�
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Cell (;j Fax # ht�� GQ
Offic �?�' o� J �� vC�0E -mail
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APPLICANT INFORMATION
Check any that apply: Change of ownership ofussee� Ch nge of name New business
i �Changgee
Business Name /Type: ' °, � `� Y� � %� vYX X4 S::
Previous Business on this site
sue.
Describe the proposed business including use, number of emplo , num er if av ' ble pa aces, numbe f
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 the owner's permission to use the space indicated on this application. I also certify that the information provided
is true and accurate to thelbestlpf my krAledge. I have read the conditions of approval, and I understand1them, and that I will abide by them.
Signature Printed A D
AP OVAL INFORMATION
[VI 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
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Zoning Official Date X12 dJ 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