HomeMy WebLinkAboutCLE200600092 Legacy Document 2014-07-16'IIIJI r
Application for Zoning Clearance1._:. F
OFFICE USE ONLY
❑ Zoning Clearance = $35 CLE #
PLEASE REVIEW ALL 3 SHEETS Check # 9 Date:
Receipt #6 41 07 Staff- 6".
PARCEL INFORMATION
Tax Map and Parcel: CLIP / 00 - 015 - VV - t�b- Existing Zoning
Parcel Owner:D8"
Parcel Address: $A"0mC r' k J(_ City ` l J - C State )6 Zi 1:;t 9b i
-------------------------------------------------- include suite or floor) ------------------------------------------------------------
• lud suite -
PRIMARY CONTACT.
't
Who should we call/write concerning this project? �Z66* bi lest, (dr Q U�
3a �- �� eA- yVXCr- �- City ' rr n p
Address : �i � � �lt� State �1� II zip -9p
Office Phone: P64 a75 lZ Cell ta f o"M-639 Fax #%N 9?? I Z9 E -mail f-Ir dS Qkp_rt2b/-\
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PROJECT INFORMATION l (( [� p
Business Name/Type: !) 1 �?? C?y IDf o DDS 1-
Previous Business on this site: R[)b L7Q� t��e iD
Proposed use: 1)94%c� _fp t-E CZ
Circle (if applicable): Fireworks / Christmas Tree
SEE CONDITIONS OF APPROVAL IF THE CLEARANCE IS FOR FIREWORK OR CHRISTMAS TREE SALES (Sheet 1) . .
*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 toot the
, best of my knowledge. I have read the conditions of approval, and` LZ � I understand them, and that I will abide by them.
Signature `1 l/1� —14A— 0 �� Printed �d ,r- k4 l'N' 00-0
- - - - - -- ---•-- ----- ----- --• ---------------------------- •------- - - - - -- -----------------•-------------------------------=-------
APPROVAL INFORMATION
j Approved as proposed [ ] Approved with conditions
1 Device and/or
[ ] Backflow device and/or current test data needed for this site.
No physical site inspection has been done for this clearance.
—� site plan.
[ ] This site complies with the site plan as of this date.
Contact ACSA 977 -4511, x119. $ac]�i10
�!urre . t Test Data deeded
Therefore, it is not a determinati d cofmn 7Ue45c1s in'g119
Building Official -P �'- ''�`-'-" Date 1 '�L 1
Zoning Official r Qc Date �i�d 6
Other Official Date
..................................... _ ti . - - -_ ------ _--- __ -. -_ --
County of Albemarle Ddparfinent of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 10/14/05 Page 2 of 4
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Reviewer to cdmplete the following:
Square footage of Use:
I N
rmitted as:
Under Section:
Supplementary regulations section:
Parking formula: �I 75 40, Ct VrO
Required spaces:
Y/N
Items to be verified in the field:
Inspector Name & Date:
Notes
1U/14/UJ rage 4 014