HomeMy WebLinkAboutCLE200600141 Legacy Document 2014-07-30Application for Zoning Clearance
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OFFICE USE ONLY � 0D ` �/ `
ED/Zoning Clearance = $35 CLE # lD
PLEASE REVIEW ALL 3 SHEETS Check # _ e? Date:
Receipt #35 Staff:
PARCEL INFORMATION
Tax Map and Parcel: V '! 5 U U — b (1 - 0 n — U Existing Zoning P U cJ
Parcel Owner:
Parcel Address: Act �i0 � b t Ll CAY , City �,,Aa4eSu, «QState y IN Zip aa9 U
(include suite or floor) ----------------------------------------------------------------
PRIMARY CONTACT
Who should we call/write concerning this project? V T iC_V2t 4-1 V_ bO yx"
Address: tr c( Lk O _t�_ i y �k t �� L'^�-✓L City CA,- _A tsk2S u l LWtate U A Zip 2Z'�'t U
Office Phone: &5 _q1 N • 5 t[i-i(Lrdll # Fax # (41+q • 02D E -mail
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PROJECT INFORMATION
Business Name/Type:—I-) l c�iG -S' A oif"%i - ot `t (3 u S
Previous Business on this site: v ✓
Proposed use: 4.. k —7 c)
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 to the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signatu Cr c_ ' Printed"-TQ�V-� e- V y o
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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
1 d 007.1,•4
Zoning Official
Other Official
Date
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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