HomeMy WebLinkAboutCLE201000154 Review Comments Zoning Clearance 2010-11-29FROM :Church of Our Saviour FAX N0. :434 -974 -6687 Jul, 29 2010 8:41AM P3
Applicati on foAx�' Zon-l" g Clearance
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PLP-ASE RE VIUM/ ALL 3 SHEETS
f+t aClt?� ante, -,(�
Tteceipt >x 4tnff;
PARCEL MORMATION
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1 ;tX Mal) 11tit1 Plircel; C� l `� ✓ ---
114u-celOw11cr: ck&H uf= Our- �yltuy+
Psweal Address: � 4� � f�l b 71 City 1 tlLb State
(include suite 01• (loor)
>< RIMAIt'Y CONTACT ^�
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Who should we coviArrlte cooucerning tWx project? -_
-166 Fhb ZV ) State 74p �
Address: City
OfDcc Iylloae; () Cold # �._ Fax fi 973 63 mall D Q, DIF9� AIQ►��Q[h
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A MICA.I T INFOli?,.lVlAT'l(:ON
Check arty Hint app(: Chan a of ovmer,Sbi Change of use CItnngc of name New buslnees
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BuslnessName /Type; C-44094W o: �� 4—Z-4Vwog—
Prcvlolis Business on this sole - Assog 'xip
Dascrlbe the proposed busluess inaludino use, number of employcoe, number of shiiits, ava£lmbla parkting -4 ptrsge, pttAtbcr of
vohicles, aitd arty ad idoital formation lut you h) rovirJe: ��t /� ayElZk�,i 5 t .[f
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"This Cleardnee wil l only be valid on tha,patoel 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 err•tify Ihat I own or have the ownv'u pormiuKion to use the apace indicated on dlis application, I also certify that the information provided
Le true and accurate to c cat ormy nowledge, I have need the condltionn of opproval, and I undorstand thom, and tint l will abide by tilom.
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Si�t)egne Printed /Z� ��I?fiEld Tie WA
AP RO VA L 7NF TIO N
Approved as proposed [ ) Approved with conditions [ ) Denicd
[ ] Back(low prevention device andfor current test data needed for rbis Situ, Contact ACSAI 977- 4511, x117,
No physical mite inepectiol) has been done fbr (hie oletlrttnce. Therefore, it is not n daterminaltlon of compliance wit the existing .
site plait.
[ ) This site dornplics with tl)e site plait AA of thir date.
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Buildutg 01xci.al Dote
Z0111ag Official DAt' e
Other Official Dote
County of A oemzrle Deportment of communtV l)eveaogmeut
401 McIntire Road CnarlotteaviUr, VA 22992 Voloe: (434),2q&5832 Fax, (434) 977-4126
Rovised 04/28/08, 10/13/09 Page 7 of 3
FROM :Church of Our Saviour FAX N❑. .434-974 -6687 Jul. 29 2010 8:42AM P4
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1,ncallc to conapTete tie tollow9)ts: 1Zeviiewei -to Complete the follbvriag:
Y !�� 5quorC Ib016,96 of 000! 1
I< u. LI, HI or PDIP zoning? If so, give applictmi ij Ctrlifird /��
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mittcd as: %lir/t1� i U/tV00'�/�tll. /C�t/)7
W II Here be f'ootl pnvparalion? Under section; OI e ✓ 0 1 .
if so, givo Applicant a Hcalih Department fonn
Zoning reviow ciun not btgitl until we recrivc approval Isom hleal(h Supplomentaty regulations section:
Dept. FAX PATE.
Circle (ho one' Iliac applies Perking fonmula:
Is p.trrrl on private well tAblwc WAter?
If privalc well, provide limb Deptartment form.
Zoning reviow cast not begin until we receive approval from ,l•ledlib Aegtdred spaces:
Dept. FAX DATE
Y N
Circle the one that a ems to be vcnricd i tl field:
Is parcel on septic o ubllc gewor7 �
Y
Wi ou be putting u {> a new sign of any Innd? If so,, ohtttin proper
Sign pemiit,Y
Permlt Inspector- 1 Ante:
1 N Notts:
Will there be Any new construction ormnovaiiona?
If so, obrein the proper Pcrmil.
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Zoninu to comnlefP fh,- fnllnwino-
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Val ' ce:
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