HomeMy WebLinkAboutCLE201000113 Review Comments Zoning Clearance 2010-06-14A.pplicati ®n fir Zonincy Clearanc e
Kzoning Clearauce = $35
OFFICE USE ONLY
Check # Date:
PLEASE REVIEW ALL 3 SIIEETS
Receipt # Staff:
PARCEL INFORMATION
i'as Map and Y:uceL 6 ) 1 ?) o —0 h nx o60CV Existing Toning �nw,nr" 7v,�i t�t�
Marcel Owner: lq nab L L�—•
Parcel Address: 9! ci7 Qa 1n Dr City Zerl(1•5lia Jae State U& Zip G
(include suite or door)
PRIMARY CONTACT
Who should we call/write concerning this project'? t @''Clr Lll
Address: (o9— gen-Y vQQAI gyp: City � G r(6 y—1 (le state Zil)��2
Office Phone: (�) —s Cell # ( 2 dZ 1ax # q& y- aZZ5j-mail 7e (a—r G/ / //1►'a
APPLICANT INFORMATION
Check any that apply: Change of ownership Change .of use Change of name New business
Business Name /Type: W
Previous Business oil this site
Describe the proposed business including use, number of employees, number of shifts available parking spaces, number o f
�°� 544
vehicles, and any additional infor ation 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.
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i hereby certify that i own or a e� the owner's permission to use the space indicated on this application, I also certify that the information provided
is true and accurate to th es�t+of my knowledge, I lave read tl rrd7lTOa of approval, and I understand them, that I will abide by them.
/and
Signature °/ rated � � 4/ �
APPROVAL INFORMA.T ON
Approved as proposed [ ] Approved with conditions [ ] Denied
] Backflow prevention device and /or cum it test data needed for this site. Contact ACSA, 977 -4511, xl 17.
[ ] No,physical site inspection has been doin 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 C Date ' f
j(`��
Zoning Official Date e/ 6>
Other Oi'ficial lllte
County of Albemarle Departs en oj; (l{p i2ity luevetopmem )
401 McIntire Road Charlottesville, VA 22 t 4 296 -5832 Fax: 434 972 -4126
Revised 04/28/08, 10/13/09 Page 2 of 3
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0
20 • C,2-1
W
Circle the one that plies
Is parcel on ►vate ) or public water?
If private well, provide Health Department form.
Zoning review can not begin until we receive approval from Health
Dept. PAX DATE
Circle the on.cdiLt applies
Is parcel on ept' r public sewer?
Y /®
Will you be putting up a new sigh of any kind? If so, obtain proper
Sign pen-nit.
Permit #
LO/ N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit # 20/D-- 4A%
1.,4- +1-.o fnliniaiinn•
Violations: V
/N
If so, List: 421 444-la-,S
Pro-Elks:
Y/
If so, List:
Yal lance:
(jY /N
If so, List: -ry
SP s.
Y N
If so, ist:
Clearances:
SDP's
Revised 04/28/08, 10/13/09 Page 3 of 3
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