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HomeMy WebLinkAboutCLE200700062 Legacy Document 2013-07-10J I' Z LCL-�� N 31 (�L 3i1�� 24a (i n I /'S G A iC1124 Tax map and parcel: Parcel Owner: Si Application for Zoning Clearance oning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS -00-60-035X0 ,y7_� pF AL@�1l9 CAS �SrL. �Fn I %RGIN�P Existing Zoning: Z--7-- I/V Parcel Address: 1 5 1 g Vio / Q- WR- 7 City C y ( I 1 e- State V IAA1 Zip zZ r (include suite or floor) Contact Person (Who should we call /write concerning this project ?): cAr t. S [ i U Address 5 S o cJA r t t7 qt Or, _ City Kuc I /- ,&r,S 11 d 1 -2 V State V Zip ZZ "Z6 Daytime Phone d) 4 5- 0 -- 47- Z 4 Fax # 43 % J E -mail Ch, h o im ail, (bLi Business Name /Type: 1) I Cc J Ct-1^ a&, -� {& 6 a+L -Z 14 ' &' e, 4 • Previous Business on this site: .5.1 -oiA e, "06R- 4-irow J-1' -S M Gyrb f e- L L- L Proposed use: C Q;-e- 6-ra4^ 4 - CC91A�1ns47e4r 4- 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. .,. - S�ignature of Business O ner or Agent Print Name AVROVAL INFORMATION [vJ Approved as proposed 41ackflow device and /or current test data needed for this site. No physical site inspection has been done for this clearance. [ ] This site complies with the site, plan as of this date. Building Official Zoning Official Other Official Date Backflow Device and/or ] Approved with conditions Contact ACSA 977 -4511, x 119 Contact ACSA 977 -4511, x119. Therefore, it is not a determination of compliance with the existing site plan. llz� r Date i� Date FOR OFFICE USE ONLY CLE # ® ®7—(8J -- Fee Amount , Date Paid 3 -N -07 By who? ���Jpi r_ h Cn /'Dh r ig Receipt # �f V79 Ck# By: ICJ 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