HomeMy WebLinkAboutCLE200700146 Legacy Document 2013-12-30N Albemarle County Department of Community Development L1 ' LO-2—e .
Application for
Zoning Clearance
Tax Map/Parcel:
Date:
Staff:
Parcel Owner: Lt Al z
CL '0 Address 40 OAI 12"� city State Zip
(include suite or floor) Existing Zoning:
......................................................................................................................................
Who should we call/write concerning this project?
City State Zip
Address
CX 0 Office Phone: Cell: �-7
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Fax: �77 319332 E-mail: 24eall
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Business Name/Type: /0
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Previous Business on this site:
Proposed use:
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*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 t t I own f have the owner's permissio to use the ce indicated on this application. I also certify that the information provided
is true and accu ate to th est of my knowledge. I hav read th dition of approval, and I understand them, and that I will abide by them.
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Signature nted VL) /1
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( ) Approved as proposed k Approved with conditions
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Building Official _A CIU:��-" Date G t 4- 1 -A
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Zoning Official
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