HomeMy WebLinkAboutCLE200700084 Legacy Document 2013-07-10I/
Application for
Zoning Clearance
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 Q
CLE # WO 7- "v
Zoning Clearance = $35
Check#
PLEASE REVIEW ALL 3 SHEETS
Receipt # G. 4g4I lg Staff:
v
PARCEL INFORMATION
l
Tax Map and Parcel: i - 31T Existing Zoning J - M
Parcel Owner: P SA U I L- lb I Q 4 C I Y L G
Coso PR-7eR UCrj:15R100 PA IOW+/
Parcel Address: S u rrC— 330 City State J Zip
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? M I C 14 C L Ctb�-M IA VO SI(- I
su I-r In
Address: 6SO PFM' 2 ? ILWY City Cokes c TCSyi��d� State VA- Zip 1)I1 It
Office Phone: C9 3q LA3 -`i207 Cell# Fax#(i3V)1sr3- 4�►3 -E -mail mCUeI -w, 40&�
t.cQw/
.APPLICANT INFORMATION
S =n%
Business Name/Type: R I 121 C
Previous Business on this site Iy C-y3 � u I L\ U I (1)
Describe the proposed business, including use, number of employees, numker of shifts, available parking spaces and any
d'dditional information that you can provide: DEV & U0O 6i,, ST W' t -ONe t at C. >tdl C P S 7j) tj CSI Si} J FT
*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
Cleafailce 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 o d e. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed Dl FP!Qi�h C.
APP VAL INFORMATION
0 [ proved 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 p n.
This
&, site complies with the site plan as of this date.
"Notes
Building Official U.R -� Date 1 `i _
,honing Official Date 2� d
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