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HomeMy WebLinkAboutCLE200800026 Legacy Document 2013-01-03Application for Zoning Clearance `I %R°IN1P ❑ Zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS 6 Tax map and parcel: / d a o© Do 0/71-/ Existing Zoning: P.1J s Parcel Owner: Parcel Address: City State V/4- Zip ZzgrJ (include suite or floor) Contact Person (Who should we call /write concerning this project ?): K�`��/✓ �� -�17I Address 1-;? � V6a &a N. C-I& ' tLC l;C- o2, City State VA Zip 27-71/ Daytime Phone) 2>3-2016-V Fax #f (y9 E -mail k L S�H-r-W-/ Z21" ��- ,gl�ov CiJ✓y1 Business Name /Type: REAL- E -SJM2= It -2 Previous Business on this site: V-O(Z.fA--4-- el c Proposed use: SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet 1) Circle (if applicable): Fireworks / Christmas Tree *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 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 of Business Owner or Agent Date Print Name APPR1JVAL INFORMATION 19 proved as proposed [ ] Approved with conditions [ �i] B� dlctlow device and /or current test data needed for this site. Contact ACSA 977 -4511, x119. 7Cuc V DCV�C4 8I1d /d [ ]�f�o physical site inspection has been done for this clearance. Therefore, it is not a determination of co e�"��ist5RI�i>�l� t�Ed This site complies with the site plan as of this date. tSA 977 -4511, x 119 Building Official Date o 0 Zoning Official 7. Date ,� 0 Other Official Date r FOR OFFICE USE ONLY ., 1 • [ ,� y CLE # 6W y Fee Amount $� �_ Date Paid O B who? Receipt # lf/ / Ck# B .d C" County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 5/1/06 Page 2 of 4