HomeMy WebLinkAboutCLE200700179 Legacy Document 2014-01-22Albemarle County Department of Community Development
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Fee of $35.00 File #: 2: 06-7
Application for Check# 97'9 le Date: -7' -/ � -o i
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Zoning- Clearance Recept# Staff:
Tax Map /Parcel:
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Parcel Owner:
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Q. o Address City mate Zip 2 ��
(Include suite or floor)
Existing Zoning:
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Who should we call/write concerning this project?
City D7 C� %/7 to Zip �� D
g Address
a o Office Phone: Cell:
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Fax: E -mail:
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Business Name/Type:
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 that o ave the owner's ermission to use the space indicated on this application. I also certify that the information provided
is true and accu to to th b st of my n6wled . I h ve rea t e conditions of approval, and I understand them, and that II will abide by them.
Signatur
Printed
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A roved with conditions
( )Approved as proposed � ( PP
Building Official P
Zoning Official 9 VV:6�t�_
Date t-76, o`1_
Date 0
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