HomeMy WebLinkAboutCLE201100192 Review Comments Zoning Clearance 2011-11-14County 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
Application for Zoning Clearance'�t�
OFFICE USE ONLY
PLEASE REVIEW ALL 3 SHEETS Check # Date:.
Receipt # Staff:
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PARCEL INFORMATION
12 -001M
Tax Map and Parcel: m °-
Existing Zoning_PbSC✓
Parcel Owner; , 140 fry P S 61.) v14 i CL C
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Parcel Address: 30 o SFFop j' - z,�-ta i(�r. City State l/ a Zip
_ 22'7
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? ya.S E/°fi - Sl'tF1 `(-SH
Address :.� \ 1 CZ L r �N G-7�tV `3 �; U �3City .,B f: �: �' G-[o v State V Zip 2z o°(
Office Phone: (2�3)?ZS --SOt/ Cell# 7-a3-42S= Sa11 Fax # E-mail y G t7 LL01
APPLICANT INFORMATION
Check any that apply: Change of ownership hange of use Change of name New business
BusinessName/Type: QV -7C7? fot�SSE'
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Previous Business on this site [ p� 't� o LL r o o � S
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: TG7�} �° tk't :5 c�Z a hP4o EE
_W 1-1-V G al A'v a 7, AP-A/? k- i=NGJ / wr PP-!�_
*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.
1 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 Printed 4/o s EPH /i SrI ELtAt s, W
APPROVAL INFORMATION
Approved as proposed ? Approved with conditions [ ) Denied
[ ] Backflow prevention device and/or current Pest data needed for this site. Contact ACSA, 9774511, xI 17.
[ ] No physical site inspection has been done for this clearance. Therefore, it is not a determination.of compliance with the existing
site plan, f; .
[ ] This site complies with the site plan as of this date.
Notes:-
Building Official c�C.� _a ,c � _ Date
Zoning Official . _ Date __I/ 2-1
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