HomeMy WebLinkAboutCLE201200188 Legacy Document 2012-10-12Application for Zoning Clearance��';`;.
CLE # _I
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OFFICE LY
V1.1
PLEASE REVIEW ALL 3 SHEETS
Check # _ Date:
Receipt # Staff.
PARCEL INFORMATION
Tax Map and Parcel: 07800 -00 -00 -5500 Existing Zoning
Parcel owner: Luxor Office Park, LLC
Parcel Address: 1430 Rolkin Court, Suite TT Charlottesvil�,grte VA zip 22911
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? Denise E LaCaur
1430 R61kin Court, Suite #301 Charlottesville
VA 22911
Address : City State Zip
office Phone: 434_j 971 -8996 Cell # 434 981- 470(pax # 434 971- 934A- 111;lil denise@denico.net
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name /Type: Infinity Management /Property Management
Previous Business on this site Not Applicable — new construction
Describe the prop osed business including use, number of employees, number of shifts, available parking spaces, number of
vehicles, and any additional information that you can pro :/icle:
*'Phis 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 Lie space indicated on this application. l also certify that the inl:orination provided
is true and accurat I the best ofnly lal edge lave read the conditions of approval, and I wlderstand them, and that I will abide by them.
Signature s Printed /
APPB,erVAL l ORMATION
[ approved as proposed [ ] Approved with conditions [ ]Denied
[ ] Backflow prevention device and /or current test data needed for this site. Contact ACSA, 977 -4511, xl 17.
[ ] No physical site inspection has been done for this clearance. Therefore, it. is not a deterrilrrlatiorl ol�coml)liance bvith the existing
site plan.
[ ] This site complies with the site plan as of this date.
Notes:
Building Official Date�f
Zoning Official it Date 13 /1 a
Othel' Official Date
l:ouuty of Albemarle Dupartnicat of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 7 /1/2011 Page 2 of 3
Intake to complete the following:
ls/
[s u n LI, III or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
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