HomeMy WebLinkAboutCLE200600111 Legacy Document 2014-07-22�
Application for Zoning Clearance
OFFICE USE ONLY -
❑ Zoning Clearance = $35 CLE #
PLEASE REVIEW ALL 3 SHEETS Check # Date:
Receipt # Staff.
PARCEL INFORMATION j
Tax Map and Parcel: �Ci 1 ( Existing Zoning
Parcel Owner:�� gam`
Parcel Address: IS; )1 10 yd • City 1 State QA Zip
(include suite or floor) ------------------------------------------------------------------
PRIMARY CONTACT 11
Who should we call/write concerning this project? _ ,,&
Address: ? `�`tr� ' /
to - 1�� 7C / City �,(��C (O•�iit ii ���State V Zip U5
Office Phone: 3 7 Cell # 5,a?- VV-13 Fax # E -mail
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I
PROJECT INFORMATI N
Business Name/Type: Z'o n". A - '4D /
- l OL 42
Pravinne Rncinncc nn this citp-
uircie (u appucaDie): r ireworxs i k.nrisLmas 1 rce
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 to the best of my knowledge. I hav ead the conditions of approval, and I understand them,, and thh I will abide by them.
Signature l _'L� Printed
------------------ - - - - -- - - - - - --
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APPROV INFORMATION
[`],Approved as proposed [ ] Approved with conditions
[ ] 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.
Therefore, it is not a determination of compliance with the existing
Device andlor
Building Official Date J� �7-A o'v
Zoning Officia c Date
Other Official Date
. ...... ................ -- ...... - - -- s -a�.. .c._... �. 2 -..
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 10/14/05 Page 2 of 4
Reviewer to complete the following:
Square footage of Use:
Y/N
mitted as: ---
Under Section:
Supplementary regulations section:
Parking formula:
Required spaces:
Y
Ite a verified in the field:
Inspector Name & Date:
I Notes
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