HomeMy WebLinkAboutCLE200700060 Legacy Document 2013-07-10t Application for a =Si'�
Zoning Clearance ci b ,,,�,N,P
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oning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
Tax map and parcel: M /_—� a T 4�_L C, Existing Zon r L—"_LE
Parcel Owner:
Parcel Address: 16 %S 64f-, LG /)e�{ Unrr 6 City 6114rlonn-di2 State 1/1# Zip 22162-
(include suite or floor)
Contact Person (Who should we call /write concerning this project ?): &J 4W � 13e-_4CAX
Address -2 fiykbf?„ /Aid City S�G� ai11P" State ✓A Zip 2-2V,3
Daytime Phone tl(�) fl�eQ— 1� 393_ Fax # �)
E -mail EAi --.i; /.,G 0 hbr»,4;1 -6os-Pi %
Business Name /Type:ch J-nG
Previous Business on this site: r_.
Proposed use: rYf iC� 5p&ct -Fo rGl oyyw_/—�ta Wr
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.
3—J,6—a2
Si ature of Business er or Agent Date ,
Vwc,yv -e
Print Name
APPROVAL INFORMATION
[ ] Approved as proposed [proved 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.
[ ]
TI ' site complie with the site lan as of t1�is da e. /
CPS 01'l.�j �
Building Official K Date. _A 01
Zoning Official K N11 Date 0
Other Official Date
FOR OFFICE USE ONLY CLE #aQD7--(aQ p� y y y
Fee Amount $ 5aV0 Date Paid 3`l�j-p "7 By who? �' ! C cei t # Ck# �/ / B �f9
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