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HomeMy WebLinkAboutCLE200700076 Legacy Document 2013-07-10Application for Zoning Clearance t'.TFtGli�l� County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 511106 Page 2 of 3 OFFICE USE ONLY -7 ❑ Zoning Clearance = $35 CLE # 'goo Check # Date: PLEASE REVIEW ALL 3 SHEETS Receipt #I & Staff: ryl.2` i, 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? 1(to-©OE�CL�L IA e i ill . LZ City IrGL State VrT Zip a��3 Address: Office Phone: (4L4) 979—x5 DO Cell # q 91- 51 r/Co Fax # 9`7 9 — 600 ( E -mail GCo=,odn o(, 00% ac APPLICANT INFORMATION Business Name /Type: Fluvanna County High School Band Boosters Business (?CL(( L30A Previous on this site Describe the proposed business, including use, number of employees, number c shifts, available parking s aces and any , additional information that you can provide: 0C _( rr, taut_ a- C v - ( t It ►� In a r� 1r of 51%t� C ,wVw - OJoon ccr� ►�a�r` - ,0 , *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 acc at to i best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature Printed 1 {� a - �2 (Ct�l®C APPRO 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 Other Official Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 511106 Page 2 of 3