HomeMy WebLinkAboutCLE200700026 Legacy Document 2013-05-22Application for
Zoning Clearance
mng Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
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Tax map and parcel: t�P 9 0 o — o o— oo — (90 5 ate Existing Zoning: Ciy
Parcel Owner: /\J �-'ii�.�7 d k,- 1 1-1-7 -a
Parcel Address: \,qR % & - /G,� (2,0 oi'y ti" r-+ k) za a ' State Zip
(include suite or floor)
Contact Person (Who should we call /write concerning this project ?):
C—C Y'w e- 6,k of
Address lo4G by -Mleit: o e, Lim City GA(KyH ifi le State __ Zip D -11111
Daytime Phone �t �—n � Fax # ( 1� 1 _ E -mail be-hel (q 690 k0 fwkai,1 a Cam)
Business Name /Type: C=caS 0� y�i✓� (�i✓�����
Previous Business on 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
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. �r�w
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Signature of-IBusiness O er„o Agent Date ,
Own K)
Print Name
APPROVAL INFORMATION
[VI Approved as proposed [ ' j Approved with conditions
[ ] Bac flow device and/or current test data needed for this site. Contact ACSA 977 -4511, x119.
o physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing site plan.
[ ] T ' site compl' s with the site an as of this djpte.,,
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Building Official
Zoning Official
Other Official og WVA-C
Date I ; •:'�
Date .1(/ �,ol
Date 41 Jb7
FOR OFFICE USE ONLY CLE # Z'd- 7�- ca' fl%
Fee Amount $35 1040 Date Paid 1-25-07 By who? W yo K y Q1 NA Receipt # _&31755 Ck# By:
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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 4