HomeMy WebLinkAboutCLE200700211 Legacy Document 2014-04-25Albemarle County Department of Community Development
Application for
Zoning Clearance
Tax Map /Parcel: w— b,0)2
Fee of $35.00
Check #
Recept #
- DOZOD
— °Parcel Owner:
Q. `o Address ,� �G =��' /� ��G� G City tate Zip
(Include suite or floor) /�
Existing Zoning: C� '
Who should we call /write concerning this project?
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c ,o Address
Q. o Office Phone: J ✓ ✓�7�1 1 Cell:
Fax: / 7 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 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 of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed
--- •--------- •-- --................................ - -• -- ........ - - -... ----------------------------- - - - - -- - - --
) Approved as proposed ( )Approved with conditions
Building Official
Zoning Official
Date wa � 1
Date 2 J%
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