HomeMy WebLinkAboutCLE200700008 Legacy Document 2013-05-22.J
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Application for x 0�w' Zoning C learance 'rrtct:�`
OFFICE USE ONLY
Zoning Clearance = $35 CLE # 00°7
PLEASE REVIEW ALL 3 SHEETS Check # )35.5 Date: 1-5-67
Receipt # 63,5&0 Staff. d Q-
PARCEL INFORMATION (ry ,J 0 , OQ &) 0(
Tax Map and Parcel: Existing Zoning_
Parcel Owner:_(rcf6'0Vi u E /,_
Parcel Address: -23d E- Vii- 61 vie r,,w w o,-VZ- City State VA Zip d Z (O/
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? 1/ (L2 / I/— C (�� .
Address: i a kc 2 City
State Zip
Office Phone: M—Y) 21 2 l 4,! g�- Cell # S ct rA a Fax # 3�- `/ �3— E -mail U. w �' ` ()t y Si v, r`w, e d(4
3/ 8'7
APPLICANT INFORMATION
Business Name /Type: L!L!2/j/ L G • tU,+P- ltiC=72
Previous Business on this site ecc t 1�gy
Describe the proposed business, including use, number of employees, number of shifts, available parking spaces and any
additional information that you can provide: /i u c`cci f !�cLi v /oe, y row d,.t c--/-
*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 �0 b Printed I�tC4 //i_L
AP OVAL INFORMATION
[ proved as proposed [ ] Approved with conditions [ ] Denied
Bpckflow prevention device and /or current test data needed for this site. Contact ACSA, 977- 1
[ vi &o physical site inspection has been done for this clearance. Therefore, it is not a detenninatio of cA hftW4 e1&@ice
site plan. Current Test Data Need d
[ ] This site complies with the site plan as of this date. Contact ACSA 977 -4511, x1 19
Notes:
Building Official Date i —t
Zoning Official Date 2 Z &(
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
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