Loading...
HomeMy WebLinkAboutCLE200700005 Legacy Document 2013-05-22•,;.oL)l —°-5 Application for ;n f , Zoning Clearance C�� Zoning Clearance = $35 �— — -P /© 0 2 �� PLEASE REVIEW ALL 3 SHEETS ,-,`a xyL ,Ve0( 4 S Tax map and parcel: 06 1 ITS (,6 Existing Zoning: Parcel Owner: ��iN�r ,� �,�.�✓3 ` ` ` �) Parcel Address: 1, t� &,"c k --P7j^ �i�,, City Cllr Sr��, �. State 11 Zip (include suite or floor) Contact Person (Who should we call /write concerning this project ?): MA (�r� �`�'� ✓� Address L G 2,CD �— Y~e_ k_C_-v -C-1 LS State Zip 2- 2_06 j Daytime Phone ( 18r, °' 014 1 G. Fax (&219. % "' i -mail 4c �e� innoC 6 I 00 i�4� �'Zv� t ►� Business Name /Type: .r ✓.v� �i,�< �t�ir,/.st/ .- eG.nG�✓t,CQ. TO'7 Previous Business onn this site: Proposed use: 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 pro tded 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 abi &bv them. S11nature of Business Owner or X�ent Print Name Date APPROVAL INFORMATION LC,nta,, flow Device and/or Approved as proposed [ ] Approved with conditions t Test Data Needed ACSA 977 -45 11, a 119 [ ] 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 of compliance with the existing site p [ ] This site complies with the site plan as of this date. Building Official Date t 1, rt 1 Zoning Official Date I o Other Official �_ Date FOR OFFICE USE ONLY # e Z O -7 — 5 Fee Amount $ 35,00 Date Paid 1 -g-0"7 By who? OVO/V SC Receipt to a / Ckff /00:7 By: C �� 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