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CLE200700068 Legacy Document 2013-07-10
d Application for Zoning Clearance � �1tC1lT:lA 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 3 /l G i lw 1 '.[1 19 OFFICE USE OS� oning Clearance = $35 CLE # Check # Date: —30 o. PLEASE REVIEW ALL 3 SHEETS Receipt #6492P-- Staff: PARCEL INFORMATIOgN •� ^ DmTax A N Map and Parcel: lit /3 Existing ning 1— C C'vll Parcel Owner: I '(�i ✓�h, iA(YG S�yUP l cL7 � � �/ Parcel Address: CIO"- City G"�'� ��/State Zip IV) (include suite or floor' PRIMARY CONTACT /� 6d I V Who should we call /write concerning this project? Address : O /� � a City �4 5 L'✓State ✓� Zip.n T- O Phone: "�� ell #� � �Z ax #3� 71 110? � E -mail APPLICANT INFORMATION ii „ �l V A 1 y Th� fir 1 Name/Type: Business I�` i ,� Business O ✓ /�� Previous on this site G'' 1 (.'� Describe the proposed business, including use, number of employees, numbeyof shift avai ble parking-spars- and any additional information that you can provide: Pi -21-71A V o -� { Zy " © G —r��s ►� (? �' c— *This Clearance will only be valid on the parcel for which it is approved. If you ch nge, intensify or move the use to a new location, a new Zoning Clearance will be required. I hereby certify that I own or have t c�I'er's permission to use the space indicated on this application. I also certify that the information provided is true and accurate to the asst o knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. /�. Signature Printed AP ROVAL I FORMATION [VIpproved as proposed [ ] Approved with conditions [ ] Denied [ Bacicflow prevention device and /or current test data needed for this site. Contact ACSA, 977 -4511, xl 19. [r\o physical site inspection has been done for this clearance. Therefore, it is not a determination co ae ow Device and/o site plan. [ ] This site complies with the site plan as of this date. Current Test Data Need, Notes: Contact ACSA 97T-451 i Building Official Date Zoning Official Date ✓ -7 pp,, A, Other Official Q (i Owju-i Date 44 l b 7 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 3 /l G i lw 1 '.[1 19