HomeMy WebLinkAboutCLE201100086 Review Comments Zoning Clearance 2011-06-08Application for Zoning Clearance
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CLE # 2n I .- 8(-,
OFFICE USE ONLY
PLEASE REVIEW ALL 3 SHEETS
Check # Date: 5):5/(
Receipt # Sa750 Staff:
PARCEL INFORMATIQ
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Tax Map and Parcel: Existing Zoning
Parcel Ownerj_))--(_1/ L4,� VGA U
Parcel Address: I _� 6 !�_ S- C4,r,,, "a L--- " 1 - City _�(,� v b State UC- . Zip )-'A %
(include suite or floor)
PRIMARY CONTACT n
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Who should we call /write concerning this project? ,{ ytcX L 'Sj.2
Address: 'q (s (J CG,t\ -fJ 6 L H U City State U, Zip N
Office Phone: L_) Cell # JE>0- 5 72 L Fax # E -mail
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
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Business Name /Type: U
Previous Business on this site �-
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:
*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 or have the owner's permission to use the space indicated on this application. I also certify that the information provided
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is true and accur e t of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
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Signature ti^-� mil` Printed �h -1�<- ��n C,CU++
APPROVAL INFORMATION
[ ] Approved as proposed V] 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 -Iz:� y /
Zoning Official _ Date �14zll
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 1/1/2011 Page 2 of 3
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