HomeMy WebLinkAboutCLE200700079 ApplicationPatriot Commercial Contractors, Inc.
Daniel 'finer
Superintendent d' &`]
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6802 Paragon Place Aad9@99•�.5 Cell
Suite 110 804- 288 -3006 Office
Richmond, VA 23230 804- 288 -3066 Fax
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'ICE USE ONLY _
# 7-pC?-7 -79
# �I U 4 L_ Date:
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PARCEL INFORMATION
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Tax Map and Parcel: e 7 z / 2 ) i Existing Zoning f" f�) M C
Parcel Owner: BI(A-e �Ztdge `►plume(- � C S, Zvi c . Ouvyief -s' "Ed W,Ifmt\15, 1�1+ 1 SCkn
'Place
Parcel Address: Sui�� ZSO �� City CKAr`AeSV11LP .
(include suite or floor)
State V1 FS1.n t v- Zip22") I I
PRIMARY CONTACT t-� I
Who should we call /write concerning this project? f'r I t' SChny�_t Ic..5
Address: C 5 6ef- Te�rSa�Pjou, S lf-e 7-;-0 City Char lml egy► I tZ State V) fzil n l o\- Zip2-2`) I I
Office Phone: ( I�li7i" 4 Cell 11 ? 5 3 g6 Fax #� ��� Z}I E -mail it 4, sckrl, 4
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APPLICANT INFORMATION (r'
Business Name /Type: e iigme' ri n q S o"1_411aCl i^ e✓
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Previous Business on this site rlbn.¢,
Describe the proposed business, including use, number of employees, number of shifts, available parking spaces and any
additional information that you can provide: cL,rren4-1,_1 35
P rrh W Of-
*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.
Signature "A_t w Printed R` ILL 3— sc vt i ip le
APROVAL 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 h N o `-
Zoning Official Date / 0 A
Other Official Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
5/1/06 Page 2 of 3