HomeMy WebLinkAboutCLE200700023 Legacy Document 2013-05-22Appucation for
Zoning Clearance
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LJ Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
Tax ntap and parcel; 46 C Zo —0;3- DO 2,00 /7 0 4 26P-60 Existing Zoning: i" tLD
Parcel Owner: �b %I l `- K t- 1R
Parcel Address: City (,/) q/7 �t't �� ��>I� State Zip
(include suite or floor) ,[( j
Contact Person (Who should we call /write concerning this project ?): Ze/w/4 01 / ' y IdAtZ d
Address/ —1) 1iche%iA O/p (Z. e- City�,Al mMe- Twl, state 4 p� Zip z ZP(
Daytime Phone 1 r �� V U Fax # �il L E -mail W �1 b W iq 1Z d `V C Pc Co M'
Business Name /Type: ��%1y /+(C iL&_ Se /Z Vic"-
Previous Business on this site: C,�h ti tz C /
Proposed use: (/ C_�R. �J %f C cl /tZr?- �L'Gi t� 4 CGG, 115V
d- S 6+4tm
C� t (ti 5 t ihQ
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
a bide -1 them.
Signature of Business O. ner or Agentr Date
Print Name
Backtlow Duce 4111410r _
APPROVAL INFORMATION
[ -,pproved as proposed
[��Backtlow device and /or current test data needed for this site.
�] No physical site inspection has been done for this clearance.
This site complies with the site plan as of this date.
Contact ACSA 977-451L z 119
] Approved with conditions
Contact ACSA 977 -4511, xl 19.
Therefore, it is not a determination of compliance with the existing site plan.
Building Official I. Date _
Zoning Official _ Date — 24 V2 1 6
Other Official Date
FOR OF.FI . + S 1`ILY
- Fee Amount $ Date Paid By wh11El Receipt it Ow— By:
. 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 ol'4