HomeMy WebLinkAboutCLE200700081 Legacy Document 2013-07-10Application for
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Zoning Clearance`µ
OFFICE USE ONLY
oning Clearance = $35 CLE #
PLEASE REVIEW ALL 3 SHEETS Check # _ 16D Date: 4 - -0 °7
Receipt # to L - 9,-1 (2 Staff. r)
PARCEL INFORMATIO-N'� pom — Tax Map and Parcel: / / Existing Zoning C
Parcel Owner:
(� �����orV �9R�G✓�'I
Parcel Address: Sz� City G�./.E%jZQZ;E T / /(J, State i/4 Zip
(include suite or floor)
PRIMARY CONTACT //??
Who should we call/write concerning this project? jQ� /,+� F-R Few /il e /7 a ,o/M.,&-
Address :�70�FACL,��FN�7/S� /2�AJ> City 9C616916 State AhA zip �
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Office Phone:( ) Z 2'''•° Cell # / • Z52,6012- Fax # E -mail /` :rc q
APPLICANT INFORMATION
Business Name/Type: /N ,PZ.5' WAI Z1a/�TC'A L 96 �
Previous Business on this site
Describe the proposed business, including use, number of employees, number of shifts, available parking spaces and any
additional information that you can provide: A/01AIISrl?A M / PW9 N6y W_P' —ta 7:0M -6PA,?
*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 pen . ion to use the space indicated on this application. I also certify that the information provided
is true and accurate to the best of knowle ve read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed M41,>,1' lu
APPR 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.
(Votes:
Building Official
Zoning Official
Other Official
County of Albemarle I )evelopment
401 McIntire Road Charlottesville 332 Fax: (434) 972 -4126
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