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CLE200600122 Legacy Document 2014-07-24
4 Application for Zoning Clearance [I-zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS PARCEL INFORMATION qZ� -lv� OFFICE USE ONLY CLE# 7_00to-1 Z Z Check # / / (6 !7 Date: $ ! Receipt # [n 66 l-7 Staff: 1- I v Tax Map and Parcel: ©-7tko 04 -D© — 001 C Q Existing Zoning /1l /-)I Parcel Owner:/, P DnaLd Q Dl ebiGL Co tlAl ems, Parcel Address: 6o_e-:'- / �1 CL(?e, Dr- City State Il Zip '--�Jc/D/ (include suite or floor) ------------------- - - - - -- ----------------------- - ------------------------------------------- - - - - -- ------------------------------------------ PRIMARY CONTACT Who should we call/write concerning this project? rem A Address : ' ®-tic ��.c City ( / /�l %DSk;d;1� State W Zip Office Phone: d3�-�I7% U50 Cell # Fax # J ,771Y10 E -mail -------------------------------------------------------------------------------- - - - - -- ------------------------------------------ .- __.... PROJECT INFORMATION BusinessName/Type: /1/l� /5���p_, rac Av L�11AJa_.1- )q556Gr`Cc��S Previous Business on this site: Q%? 64171 on Si /� ', �bL //(�� /Z (�G�r'/7�Cc�0 , • C.: Proposed use: 'VU5/ 5'S ri72LI 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= o the best of my kno ledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signatur Printed ` .�/ E't� coy -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - _ APPROVAL INFORMATION [ ]Approved as proposed [�] Approved with conditions -1 [ ] 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 Backflow Device and/or Building Official �, _� c�rQ �� , Date C a (3 C. Zoning Official _ /�rµK.l� Date Other Official Date --------------- - - - - -- ----------- _ a%.. -- - -- - ---- - - - - -- - - - - - -- 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 P i' �I Reviewsr to complete the following I �} Square footage of Use: I T �yN mitted as:J Under Section: r . Supplementary regulations section: Parking formula: 0 Required spaces: Y/N Items to be verified in the field: Inspector Name & Date: Notes 1 10/14/05 Page 4 of 4