HomeMy WebLinkAboutCLE200700007 Legacy Document 2013-05-22Application for
Zoning Clearance
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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OFFICE USE ONLY (,o -7_ C,-7
Zoning Clearance = $35
CLE #
Check # Date: ' _ S - 07
PLEASE REVIEW ALL 3 SHEETS
Receipt # �Qy�,c5 7 Staff:
PARCEL INFORMATION
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Tax Map and Parcel: d io / tu t) — 01 _ 06 — 00 to o t) Existing Zoning L.:1D rn rn
Parcel Owner:_ r-1 soo, " New ma t t se C p
&i'� � �
Parcel Address: 235 Ctw" Vti City 0 v d La, State V h z�b
Zip
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project?
Address: 2W5 Q7myy\; iR Pm ftt-1 D r City C� ✓l Lo-- State yA" Zip
Office Phone: 9 '9'4° 9 lLIRCell # Fax # 9 -4'3— E -mail (a)
v) 1C_ Y-e-r
APPLICANT INFORMATIO
Business Name /Type: �tv�lCC��
Previous Business on this site —Fl4k KP_'�J 4-bLI';'e ez) -
Describe the proposed business, including use, number of employees, number of s 'fts, available parking spaces and any
A �
additional information that you can provide: i7V7)y0e_ 10 v-T n 4 CVtdd WV') J.
664106- lipmm
*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 C6 U.:,<�Lt,M� Cp,//L ,ICI 17 Printed AVjL'a" Mao -
OVAL INFORMATION
Lproved as proposed [ ] Approved with conditions
7
LDegid. Ba kfllow prevention device an d/or current test data needed for this site. Contact ACSA, 977 -� �� o h sical site ins ection has been done for this clearance. Therefore it is not a determinati P P
t Data Need
tte plan, A 977 -4511, s
[ ] This site complies with the site plan as of this date.
Notes:
Building`Official Date I I n o
Zoning Official �/ - ` Date
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
19