HomeMy WebLinkAboutCLE200700075 Legacy Document 2013-07-101
Application f ®r
Zoning Clearance
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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 - � 5
Zoning Clearance = $35
CLE # 100-7 -� /
Check # J�o t4 _ Date: W30 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
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Who should we call /write concerning this project? I Qo— )om d
Address: (oZ�Q �� � 2(SC11 �br LZ City ?0 (yjA 4 rCL State V s—T Zip (03
Office Phone: (4 ) 979—x500 Cell # % RJ — 5f5Co Fax # 97 1 — 0Od E -mail Q07 ac
APPLICANT INFORMATION
Business Name /Type: Fluvanna County High School Band Boosters
Previous Business on this site l U
Describe the proposed business, including use, number of employees, number of shifts, available parking spaces and any
additional information that you can provide: Q ( p ) r a-cs -2.
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L ul4n - Noon alLd r0CD7�- -
*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 accu at to best of my knowledge. I have read the conditions of approval, and [ understand them, and that I will abide by them.
Signature Printed C I(�lC< �CiD2ICt /1G�C
APPRO�AL INFORMATION
Approved as proposed [ ] Approved with conditions [ ] Denied
�[,/I
] 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 _U,,�,�,�� �— c Date
l ko
Zoning Official Date
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