HomeMy WebLinkAboutCLE200700073 Legacy Document 2013-07-10i
Application for
Zoning
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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
5/l/06 Page 2 of 3
OFFICE USE ONLY —7
Zoning Clearance = $35
CLE # 2 Oe� !
Check # Date: L id/t 7
PLEASE REVIEW ALL 3 SHEETS
Receipt # Staff:
PARCEL INFORMATION
Tax Map and Parcel: _ 04500- 00 -068D2 Existing Zoning Hgwy Comm
Parcel Owner: Sams's Real Estate Business Trust
Parcel Address:_ 970 Hilton Heights Road City _ Charlottesville _ State _ VA Zip _22901_
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? j �Q- �( I0-yz
Address : (o� �� �S O�1 �>r Q City ?a (yj1j y I-CL State V Pr Zip � �I (a3
Office Phone: 3q 9 79'x5 b0 Cell # %21-515C0 Fax # 97 9 - D00I E -mail �io-!gae )rcn 007 g ao(
APPLICANT INFORMATION
Business Name /Type: Fluvanna County High School Band Boosters
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Previous Business on this site t
Describe the proposed business, including use, number of employees, number of shifts, available parking s aces and any ,
additional information that you can provide: Q-q ( ,r, 1 iGt c�
C v our - t l
4� 1,2� kA-re in a ,c a s Q - Noor\ arLd rum -
'"Thus 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. l also certify that the information provided
is true and accu at to best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed � it/c, �2(mc,
AP RO AL INFORMATION
Approved 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 determination of compliance with the existing
site plan.
[ ] This site complies with the site plan as of this date.
Notes:
Building Official Date
Zoning Official Date IV640
Other Official Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
5/l/06 Page 2 of 3