HomeMy WebLinkAboutCLE200700240 Application�- Albemarle County Department of Community Development
Application for
Zoning Clearance
Tax Map /Parcel: 0 `7`' 5
Fee of
Check #�j/
Recept #
_00-000
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File #: '1')(0 "7
Date: 61 O35
Staff:
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—0 � ° Parcel Owner:
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nL. o Address 96a 1111�aN Amlrs � City (�f ,dLO/ State yi� Zip
(Include suite or floor) " / ,,� l
Existing Zoning:
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Who should we call /write concerning this project?
.0 Address ��Q G�//� ��� A) City eAk .State bo Zip 2� 0
aM ! 7� �� 7 X�Z�9 Cell:
c Office Phone:
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Fax: �2 / (� E -mail:
= Business Name/Type:
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Previous Business on this site:
c Proposed use %/1�1�0,�¢,� l� �` Z
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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 owne permission to use the sp indicated on this application. I also certify that the information provided
is true and accurate to- the �best of my ow d read the co itions of approval, and I understand them, and that I will abide by them.
Signature G %?" Printed ✓ / ' '��` ✓r�� r`Ui
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..._.,, -App proposed - --
A roved as ro osed ( )Approved with conditions
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Building Official
Zoning Official
Date
Date
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