HomeMy WebLinkAboutCLE200700027 Legacy Document 2013-05-22Application for
Zoning Clearance
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OFFICE USE ONLY %
Zoning Clearance = $35 CLE # Z. CJ® .7 - � / ,
PLEASE REVIEW ALL 3 SHEETS Check # ' Date: 1130 0�
Receipt # /i?► �i�C� Staff:
PARCEL INFORMATION
Tax Map and Parcel: mq M000boo oco
Parcel Owner:
Existing Zoning N�,J�Inb(5-AXS r `OU
0101 v��`"nwoo& �i'� ^,-
Parcel Address: 1.-r 4, *_ . s y► � �t71 'fib 3 City CAA' �� State
(include suite or floor) � 3 p t.l
PRIMARY CONTACT
Who should we call /write concerning this project?
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Address : �Oa0 T E ILVO -a(K 0Ln C Q. City � 1 t V t
VA . z i I)faal o ,I
State VA
Zip F
Office Phone: l I J -1) 11CK- 1_1(0( Cell # �'Lia'�J ��1 Fax # q _2S -0 11 8' E -mail Q"OV e g 6YVW RJ_
5�Acecsy . co yt._
APPLICANT INFORMATION
Business Name /Type: 13 A Y-Ck C WSW
I P,�oFess�cmc� Vl'= -
1 ' CQM, 51A_L+0LA Ali
Previous Business on this site Ii cy),el
Describe the proposed business, including use, number of employees, number of shifts, available parking spaces and any
additional information that you can provide: �ecA&,LU4 oFFfi(1p ;
.,Q 1 1 1 0 4-AAA A n U/lM VD( � (Ap A '. t-7 A 0 "SIA 1 k__T_ ' MCAA,V -kAArA -
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 �theconditions of proval, and I understand them, and that I will abide by them.
Signature i n t e d.
APPROVAL INFORMATION
[ ] pppoved as proposed [ ] Approved with conditions [ ] Denied
Backflow prevention 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 determin long �rID1b* tb Jfim& flli5ting
sit lan. Current Test Data Needed
[ ] This site complies with the site plan as of this date. I Contact ACSA 977 -4511, x 119
Notes: F2,-Ib 4d4d 3/ 1:7
Building Official r Date -,,�.,., SI "i
Zoning Official Date /M� /0-7
Other Official
Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
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