HomeMy WebLinkAboutCLE200900170 Review Comments Zoning Clearance 2010-10-08— a
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-- A -_ 1icafion _for Zon_ n Clearan-c-
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Zoning Clearance = $35
OFFICE USE ONLY
Check # I L Date:
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- -- — - --"PLEASE REVIEW ALL-3 SHEETS- "- - - - -_-
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Recei t # - p �D� Staff:
PARCEL INFORMATION // i
Parcel: �1 Existing Zoning I✓
Tax Map and /
Parcel Address: itkJ42L . t Av S, City Tai v,% If State Zip
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? �•� > DzL+vat�`✓��
Address: SvA )u )._ . il" FJ4 dPainq Qi City Vii, 141 State Zip 22-9a
Office Phone: -101 Cell # 2-4) L 2.4 Fax # 24f` 3 i1 P E -mail I i )i44 S-q C 4 mm4, ' +
APPLICANT INFORMATION loe
Check any that apply: Change of ownership Change of use Change of name New business
Business Name /Type: SAU*k
Previous Business on this site 404 kocw i Av Le owi-ara"Alp , Vh,
Describe the proposed business including use, number of employees, number of shifts, available parking spaces number of
vehicles, and any additional information that you can provide: �aAiyy�� fiilikints - A_
�ekQc4a� _
*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.
Signature liv-PrinteddL - �IZWiI�
APPROVAL INFORMATIO -
[ Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, x119.
[ ] 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 e
Zoning Official Date D t)
-_ W)m
Other Official Date
County of Albemarle Department of community iieveiopment
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 04/28/08 Page 2 of 3