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HomeMy WebLinkAboutCLE200700277 Legacy Document 2014-04-28L ' 4 7 Application for Zoning Clearance .iii r�, •'� County of Albemarle Department of Community Development 4 1 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 5/1/06 Page 2 of 3 CIO d I OFFICE USE ON Y 7 �Z� �l Zoning Clearance= $35 CLG # PLEASE REVIEW ALL 3 SHEETS Check # Date: 11-1g, Receipt # Staff: t /•-r5 PARCEL INFORMATION n Tax Map and Parcel: r/ " 13; 3 Existing Zoning /^ ' S G Parcel Owner: S �/ Pl�Ui4 G CC Al 76-d",d •Y5'0 C, c' / O S I^ M � �' 3 Parcel Address:—/ - i o I i 0/'1- City C- l Vi i / State va .- Zip 22701 (include suite or floor) PRIMARY CONTACT _ Who should we call /write concerning this project? Mss P �� %} $ /I L%/I S Ft Address: J L} j IA,' 6=W Pbq< L A.) L City W A S j* 1 ,v CZ,, Btate "D C Zip :10 010- Office Phone: (gp3) `3-2. 5� -5 (( Cell # 5 -5 u jiax # Ep 14.- /4 APPLICANT INFORMATION Business Name /Type: j g.. N -1 R C H R c S °•T CA (A'S C(K' L P- S Previous Business on this site 9 RI;R kC' T fy C_ Describe the proposed business, including use, number of employees, number of shifts, available parking spaces and any additional information that you can provide: "T R �, E <; R UF S p '3 E M 9LWVt, F= S ) 2 S. l -i• C ('-'C• S� *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 us ethe space indicated on this application. I also certify that the information provided is true and accurate to the best of my knowledge. IIhhave read theconditions of approval, and I understand them, and that I will abide by them. Signature ��`�"" Printed VoS E PH )qS%-j L: LGtl 5 APPROVAL INFORMATION [ ] Approved as proposed ] Approved with conditions [ ] Denied [ ] Backflow prevention device and /or current test data needed for this site. Contact ACSA, 977 -451 I, xl 19. [ ] No physical site inspection has been done for this clearance. Therefore, it is not a determination of corppliance with the existing site plan. [ ] This site complies with the site plan as of this ate. �4�f N(A- �` DE �f �� �� D!� �C�. Notes: Mu5 i CbI-A1Et,� W t'i 4 -EIVS A-i'vu° I Building Official v Date —i t �-� 0"1 Zoning Official A Date YN IG #eOfficial a `�' Date l" 1 County of Albemarle Department of Community Development 4 1 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 5/1/06 Page 2 of 3 CIO d I