HomeMy WebLinkAboutCLE200700019 Legacy Document 2013-05-22r p.` plication for O,, in Clearance ,x,N,P
® Zoning Clearance = $35
N,� EASE REVIEW ALL 3 SHEETS
Tax map and parcel 6b, :d V � " ° 4)� �� � fJ � Existing Zoning:
Parcel Owner: TA YA KU M
Parcel Address: 14_1 56 C1RkEN'(3'1zAE1 - ?L_ City ����� ��1E5L1� i State VA zipT2-lyZ
(include suite or floor)
Contact Person (Who should we call /write concerning this project ?): �'� �sl� �� A
Address V b �9,9 5 T O W E CQE iv iC U-J ,, #00P, City C-1 A21.- 0TTE5u1 LLC State V Zip ?-2-1(0
Daytime Phone (goi) �3 _- 3 f{ 9LV S Fax # &TA -- E -mail -JA-16 `� CO M A O 1 A " Co ej
Business Name /Type: �>J 0D
Previous Business on this site:
S M A 2'f �_C— A lZ N i N (�i 5 21J I DES
SAME 51F"\CJE—_ ..
Proposed use: EDGE C A 1 I orJ / L& �q -(2-pJ 1 f\) 61 siE�; 6LU' i LES
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
"TA y 911 AtSV—A Iz ,A
Print Name
APPROVAL INFORMATION
[ ] Approved as proposed [I/Approved with conditions
VB ckflow device and/or current test data needed for this site. Contact ACSA 977 -4511, x119.
Q/] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing site plan.
L ] 'Ri_is sit ecomplies with the fit@ play as of this date. _ A -1/ _ _ - _ ►, sn/Lr. . n _cr_ _ 1. n
Building Official Date i
Zoning Official Date 2
Other Official Date
FOR OFFICE, ' NLY
CLE #
Wr/_t Cl
Fee Amount $ Date Paid
By who?
Receipt # Ck
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 of4