HomeMy WebLinkAboutCLE200700011 Legacy Document 2013-05-22Application for (Alg, j),, Zoning Clearance x,NP
❑ Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
Tax map and parcel: O 61a i,Syl)11Q ( qCe Ci n ' Existing Zoning: tAm ►Yt C tlili' - l,- , ,
Parcel Owner: , y , AAA V---
Parcel Address: E/0 k j -1 ''5 Su oe rdy1 Q4 r ' i State Zip
( , inchiHe suite or floorw6 ms s„ rU�
� � '1' 1�1 l I L
Contact Person (Who should we call /write concerning this project ?):. r V DS Vm a- Act 4 ". /�7 df
Address) y �hJY4 -Y A-A-e, /& City Vd Imo. (� State �� r Zip 201'-3
V3
+ 2 3 3 � %3 %2 E -ml D l�rl �1 'FT/1�1��x rna it �olc
Daytime Phone �S �/ 7 $' r Fax # 3 ai C
Business Name /Type: rC /all
Previous Business on this site: Sin nn e
f C S jj
Proposed use: Pit! ( (14 C ( �knV S7/1Q nUrCI ASl rt� C' Xt S'�n� G5&94 S 711
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 ap roval, and I understand them, and that I will
abide by them.. '
Signature of B siness Owner or Agent Date /
�L� fee ,M,, I�)ol�
Print Name I -
APPROVAL INFORMATION
[ ] Approved as proposed
[ ] Approved with conditions
] Backflow device and/or current test data needed for this site. Contact ACSA 977 -4511, x119.
] No physical site inspection has been done for this clearance. Therefore, it is not a determination
] This site complies with the site plan as of this date.
i • .��. i 1 "J J&- _ ---Date
Date
i�
Current TCe5A 977 -4511 9
Contact A
,wnp wi the existing site plan.
FOR OFFICE USE ONLY CLE # 1 — I
Fee Amount $ 35100 Date Paid 1-- 11 -07 By who? la n/-`hor1/ Receipt # 43&30 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 of 4