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HomeMy WebLinkAboutCLE200700082 Legacy Document 2013-07-10F/+ ' ` �1y01AL��G Application for ;,U SPCC �:�' Zoning Clearance 1 110�,� OFFICE USE ONLY ©'Zoning Clearance = $35 CLE # 7-00-7— g PLEASE REVIEW ALL 3 SHEETS Check # Date: Receipt # �fcl Q Staff - 4 >7 PARCEL INFORMATION �1Tax Map and Parcel: 1 31J Existing Zoning Parcel Owner: Jy�'J6k --' Parcel Address: _6K'0 .Z 3,f �7 a,!' i,J City &Ms✓; State 11 i Zip ZZc// (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? ; eJ /Y), °��•Q/ Address :_(.P?rU Of-LU )- Lht/r'/Q /045:J V City CAi9✓I v- J'7/��f'� State j�i¢ Zip ZZ911 Office Phone: ( _� /�,,� - -7 b i gcell # V6 %- f -e) q:3 Fax # 2 13 - `%bl-1-mail 9.tW if -0'00 C 1icL,cX'- APPLICANT INFORMATION Business Name/Type: I� Previous Business on this Describe the proposed business, including use, number of employees, number of shifts, availabl parking spaces and any additional information that you.can provide: _ Chi v /rya k/ 0 zaj4 n OS 4-: C.,- *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 t the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature Printed "�:z►��,Y�j� i�.� /f �' 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 D to __ `-� I n o- Zoning Official ��D a Other Official C'C a"Ie I County of Albemarle Depar ment of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 511106 Page 2 of 3