HomeMy WebLinkAboutCLE200700001 Legacy Document 2013-05-22Tax map and parcel:
Parcel Owner:
Application fore= °1'�
.Zoning Clearance
oning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
ega41-0
Existing Zoning: P F)-s C,
Parcel Address: ) % £ "2-`o City (.��d l a S U 1-d-( State �/�- Zip
(include suite or floor) I 1
Contact Person (Who should we call /write concerning this project ?): Loc
Address � ` o , 14 ,D,( "5� I a 9 City n f (�r_)- c3 Q 1 i14P State �J A_ Zip 2a 0
Daytime Phone Co �-5-9 S Fax # ` q,3 o?g (a E -mail �l a �✓l � 1�2Q_- �I1�ea (�-E� I �;� �[. yt(
Business Name /Type: C!a i 1`C.. _T d1 '�
Previous Business on this site: /-
Proposed use: >>5�z l l 1 o f c f j b
SEE CONDITI0_N8-A4-A1!L1L0VAL IF THE CLEARANCE IS FOR FIREWORK
Circle (if applicable): Fireworks / Christmas Tree
SALES (Sheet 1)
*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.
Sig a re of Business Own6r or ent Date
� h
Print Name
S31 O`6��
*R_ OVAL INFORMATION
Approved as proposed
[ ] Approved with conditions
[ )/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 plan.
[ ] This site complies with the site plan as of this date.
Building Official Date
Zoning Official Date /_ S - n 7
Other Official Date
FOR OFFICE USE ONLY CLE # 7_00-7— /
Fee Amount .)o Date Paid I" - -3 - -7By who? 1IGLi74a � Receipt # (03tNg' Ck #,_C399(0_ By:
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