HomeMy WebLinkAboutCLE201100088 Review Comments Zoning Clearance 2011-06-08Application for Zoning Clearance
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CLE # 2011 f
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PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY jj
Check # Date: 9/;/(
Receipt # Staff: V73�
PARCEL INFORMATION
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Tax Map and Parcel: Existing Zoning
Parcel Owner: � r-e-L i t-n
Parcel Address: L-fQ �- ��'"` "' "' 4 T�- City Cii. J 1 �- State U c, Zip z2 -`] /I
(include suite or floor)
PRIMARY CONTACT l
Who /write
should we call concerning this project?
Address: `~lC, 4 C C "ata-t- City L,,,, C J/ State )C„ Zip D-2-59 L-1
Office Phone: (_� Cell #1('6- 2-1:, Fax # E -mail
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name /Type: J 4—'+-
Previous Business on this site U L'P S a-
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 I owl 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 e be of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed.�i�-
APPROVAL INFORMATION
[ ] Approved as proposed 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 y t t
Zoning Official Date
Other Official - l _. Date &-Z-/
T �
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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