HomeMy WebLinkAboutCLE200700016 Legacy Document 2013-05-22Ut'?°'
Application for
Zoning Clearance
XA
Zoning Clearance = $35
OFFICE USE ONLY
CLE # 'Z 00 "7 - % 1p
PLEAS REVIEW ALL 3 SHEETS
Check # jf!�g Qol d µ 3 Date: 1-18-07
Receipt # &-'3-7a-7 Staff: [' 5�
PARCEL INFORMATION wv Co rn
Tax Map and Parcel: Q '14 5 00 - 00' 00 - 0 b S 0a Existing Zoning(<\
Parcel Owner: `man-\ S C� l (ill,, 0
Parcel Address: C� O �, (` R City. :6\,V Wftk State "% Zip
(include suite or floor
PRIMARY CONTACT n ',�
K�6 b'yn &_"n
Who should we call /write concerning this project? �' 1
Address:'; !u 6 bafraC4 K-� -*9- City Lg64ljK11)LL State Zipb -4-9D
�� ���� t42 43W_
Office Phone: (0J �� P�% Cell # 53f7l )-Fax # �y,�a-(¢ E -mail C &�j.
APPLICANT INF09MATION
Business Name /Type:
Previous Business on this site
Describe the proposed business, including use, number of employees, number of shifts, available parking spaces apd any
'tional
add information that you can provide: Sb'1 (Ctll� ,(
w J �
*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
Printed
AP�ROVA INFORMA
Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] B cicflow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, x119.
Zo
[ Q physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing
site plan.
[ ] This site complies with the site plan as of this date.
Notes:
Building Official Date i '-t �1
Zoning Official Date d7'
Other Official Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
511106 Page 2 of 3
0
I'Y)
9M