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HomeMy WebLinkAboutCLE200700003 Legacy Document 2013-05-22Application for Zoning Clearance o g 5]"Zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS Tax map and parcel: ()6 0 f ' Q ,:� -107 - dO3 00 Existing Zoning: C, Parcel Owner: Vv►aek_ Parcel Address: 1 Li r! 9A4k JL i" i "(,29 City ( __, VJUA�1 State �ja' Zip m I (include suite or floor) Contact Person (Who should we call /write concerning this project ?): TA" el Address City State Zip Daytime Phone L� Fax # LJ �' a`� U E -mail �� Iw► 00, A ki I Y�J ea � T � ` 60 "n Business Name /Type: O�- 60L 1G1" 01IlCA, Previous Business on this site: iT'NlV�li[/l, Proposed use: _hA(A 1 C&Lp r o-C PI c -e► 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 approval, and I understand there, and that I will abide by them. Signature odriness caner or t Date JA s% 1�1�ws go (A A M Print Name APPROVAL INFORMATION [Approved as proposed lv6ackflow device and/or current test data needed for this site. [�No physical site inspection has been done for this clearance. [ ] This site complies with the site plan as of this date. Building Official Zoning Official Other Official Backow d/ Device anor [ ]Approved with conditions' Curflrent Test Data Needed C Contact ACSA 977 -4511, x119. ontact ACSA 977 -4511, X 115 Therefore, it is not a determination of compliance with t e e i Date 11, E 1 0`1 Date Date FOR OFFICE USE ONL Y r y CLE # y ©i� p % f � Fee Amount $ '7 Date Paid � b 0 B who? r'1 Receipt # �`Ck# ! By: i County of Albemarle Department of Community Development 'd` 3d36 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 5/1/06 Page 2 of4