HomeMy WebLinkAboutCLE201000235 Review Comments Zoning Clearance 2010-11-19County ol'Albemarle Department of e.:ommunity 1)eveiopnrent
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5532 Fax: (434) 972 -4126
Revised 04/28/08, 10/13/09 Page 2 of 3
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Application for Zoning Clearance
CLE # -
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- OFFICE -USE- ONLY- -.. _..._..... — .... —..... _... ;.._..._......__..._.......
❑ Zoning Clearance = $35
Check # Date:
PLEASE REVIEW ALL 3 SHEETS
Receipt # Staff': _
Tax Map and Parcel Q 6 l W — Oo — cW — I X3 0o Existing Zoning
Parcel Otivner ;_ f,. (d Xg S o C A —tGrs r C 16 0 (A,h .t3 AA- La N
(A, C. c3 ti- M X-ti Lt- 4
Parcel Address: City C ttt y t c__LQ State LIA Zip ZZ`t (1
(include suite or floor)
PRIMARY CONTACT
&19C-M-71 C -Ty x-s
\)'lio should we callhrvrite concerning tliis project? UJ•A
Address: 3 : a�- Pd t L A-+ P—c 0 q _e / City C(f ' J I LL State UA zip 2Za (}
Office Phone: 2A C ` S f'3 lail # Fax # E -mail
APPLICANT IIITFORMATION
Check any that apply: Change of ownership Change of use Change of name Ne/w�business
Business Name /Type: �o`t Sc�n'tS' Qt-- l trrtcCF� t �'CdfVe_ b4• 9— _�(C-f`dAf \dgArCtC.,
Previous Business on this site
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
)lehicles, acrd any additional information that you can provide; %'�wD ! c rC -- C•f X(S- Z' AAA A-2-t S'
'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 [lie 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 knowleddgge..�II have read the conditions of approval, I understand them, and that I will abide by them.
/and
�
Signature Uj °9-�•�i Printed (2'jo C - -" UJAL;7e �
APPROVAL INFORMATION
[ ] Approved as proposed •WApproved with conditions [ ] Denied
[ ] Bacicflow prevention device and /or current test data needed for this site. Contact ACSA, 977 -451 1, x 117.
-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 ith the site plan as of this date.
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Building Official_ Date
ZoningOflicinl Date
Other Ol'Iieial Date
County ol'Albemarle Department of e.:ommunity 1)eveiopnrent
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5532 Fax: (434) 972 -4126
Revised 04/28/08, 10/13/09 Page 2 of 3
' si.
(2