HomeMy WebLinkAboutCLE200700002 Legacy Document 2013-05-22Application for o2 Gd -7 '
Zoning Clearance ,xN�
oning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
Tax map and parcel: V b TQ -00'-N 00119-1 Existing Zoning:
Parcel Owner: _ i T
tYt,� � ✓� ���� SG.9t rr ��r n -�
Parcel Address: QTk/►1of (f 1 City �l �/ /D77 sV,�/l e- State Y Ti Zip�a n7��
(include suite or floor) ~y— %���y v
Contact Person (Who should we call /write concerning this project ?): y / � ' /c.t ✓� LueC
Address
Daytime Phone L_) 9 -7,536;?g Fax # L_J
City
Business Name /Type: 1 F `t ?�d C IA-,;,5 ro_0 - a (I C
E -mail
State Zip
Previous Business on this site: 61,k4-c- / ' ,or Zjc, , i� '
Proposed use: L V
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 them, and that I will
abide by thew
Signatu of Business Owner or Agent
Print Name
//3 07
Date
Device and/Or
APVROVAL INFORMATION I LE�Wi&A
[ Approved as proposed [ ] Approved with conditions 9n-451E1,1 219
[V] Backflow device and/or current test data needed for this site. Contact ACSA 977 -4511, xl 19.
[VTNo physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing site plan.
[ 1 This site complies with the site plan as of this date.
Building Official
Date ___��, a•
Zoning Official
Date —� l
Other Official
Date
FOR OFFICE USE ONLY CLE # )7
Fee Amount $ �75i00 Date Paid _L-3 By who? N__rTM4i7 t.0 Receipt # (43-'/5'0 Ck # )3 1-37By: do
�b464 4_ C jC ';5aZrt222
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