HomeMy WebLinkAboutCLE200600105 Legacy Document 2014-07-22Albemarle County Department of Community.De
' Fee of $35.00 —�
✓ Pile #: �C�Q (y
Application for , Check# gf5C/ -, Date:
Recept # '(7 —7 Staff
Zoning Clearance ,frF,�Ma�z�
Tax flap /Parcel: 00 [/ a
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Parcel Owner:
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(Include suite or floor)
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Existing Zoning: �
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Who should we call /write concerning this project?
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Office
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E -mail:
Pax:
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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, anew 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 accu�ata o e owledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed
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------ --•-----`-------''t "' ( )Approved with conditions
_ ( ) Approved as p sea "��� r
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Building Official
Zoning Official
Date
Date
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