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HomeMy WebLinkAboutCLE200700018 Legacy Document 2013-05-22Application for Zoning Clearance ale zL,06--a`7 "� OFFICE USE ONLY °Zoning Clearance = $35 CLE # Zd Q•r% ­ PLEA ALL 3 SHEETS Check # Date: Receipt # Staff: PARCEL INFORMATION (� J7 Tax Map and Parcel: ~ Existing Zoning � Parcel Owner: f''`tc+�+� a �S�vG, GJ�-�c loro`�SSlp�k�) Parcel Address: j w`f ��i City State �� zips (include suite or floor) ( PRIMARY CONTACT J Who should we call/write concerning this project? 9 r14`b GL, r STS /1, S� r/ "" Address C -75 S v � ��"� °!l City C`i 4r Wk "``% State y` Zip" 7 Office Phone: CM) 3/1-1 Cell # -` Fax # SL9 15 E- mail ;,.-sti A APPLICANT INFORMATION Business Name/Type: Previous Business on this site, C Describe the proposed business, including use, number of employees, number of shifts, available parking spaces and any, additiopal information that you can provide: l— *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-_kuewlcdge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature 0Rl"; APPROVAL INF - - ' � TION [ pppoved as proposed [ ] Approved with conditions �Backflow prevention device and/or current test data needed for this site. Contact, No physical site inspection has been done for this clearance. Therefore, it is not a site plan. [ ] This site complies with the site plan as of this date. Notes: [ ] Denied Current Test Data Needed Contact ACSA 977 -4311, x 119 Building Official Date -�- I S "' Zoning Official Date 2 Other Official Date 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 of 3