HomeMy WebLinkAboutCLE200700205 Legacy Document 2014-04-25Application for
Zoning Clearance
Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY 7 — z h
CLE # �� V
Check # c Date: 1. • C
Receipt # Staff:
PARCEL INFORMATION
Tax Map and Parcel ��
aaw Buz, Existing Zoning
Parcel Owner: (j 1b Y i a Fe& i b [A 5
ss: City State Zip
(include suite or floor)
PRIMARY CONTACT ` 1 _
Who should we call /write concerning this project? `s
`?�J'a
Address c`3U5 N ,ArR ��++� City 2,A%ry1� State L/P Zip
Office Phone: ( 7y,)-(,ctV Cell # &)q-.3 tq 30Z, Fax # 5OVi0-6Z21 E -mail Schap �ec��Sec�rtirly.
APPLICANT INFORMATION
Business Name/Type: Vec-biL'SecLj
Previous Business on this site C t i ►Z,
Describe the proposed business, including use, number of employees, number of shifts available parking spaces and any
a ditional information that you can provide: Qt.J1J . ',4nl . C Cpl ice SQflee �e. �'(i°c �c
cu¢.,..L (�� ,� v�+�1 �o,�,�t,s 1'19 -IF. ,� • e►•, Iv ,cis.
*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 ac to the best of my knowledge. I have read the conditions of approval, and I understand the`m,,, and that I will abide by them.
Signa re �? �'F iC +C� ' " Printed
APPROVAL INFORMATION
[WApproved 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 cgjnplies with the site plan as of this date.
Notes: G"A 1� , sa,L& u L Le- .
d
Building Official - c Date 2TS" j "I a -1
Zoning Official Date g �24 /67
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
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