HomeMy WebLinkAboutCLE200700050 Legacy Document 2013-05-28CSC i'1l'CU --7 �
Applicatio for Zoning Clearance
OFFICE USE ONLY
Zoning Clearance = $35 CLE #
Check # Date:
PLEASE REVIEW ALL 3 SHEETS Receipt # Al Staff:
PARCEL INFORMATION
Tax Map and Parcel: 07900-00-00- O 155 5 D Existing Zoning dieAldav%
Parcel Owner: �lY►nC,o L), C, , 0 1 S3 7� vrJA -E� -
Parcel Address: P.O • b o D City C. V10..#_ State Q Zip Zeal dZ
(incl de suite _or floor)
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APPLICANT INFORMATION
Who should we call/write concerning this project?
Address: City K \Of
Office Phone: Cell #,-<31 j'F� Fax #
PROJECT INFORMATION
Business Name/Type: L
Previous Bush
Proposed use:
State VOL Zip eKg!�q
E -mail
Circle (if applicable): Fireworks / Christmas Tree
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet3)
*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.
Signatur Printed O M 117e . !4
APPROVAL INFORMATION
( ) Approved as proposed Approved with conditions
Building Official �— Date
Zoning Official Date
Other Official Date
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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