HomeMy WebLinkAboutCLE200600142 Legacy Document 2014-07-30J ➢I 11
Application for Zoning Clearance
OFFICE USE ONLY !!
oning Clearance = $35 CLE #
PLEASE REVIEW ALL 3 SHEETS Check # AA'I -- Date:
Receipt # —�^ � � � � Staff: GJ I"
PARCEL INFORMATION
Tax Map and Parcel:
Parcel
Parcel Address
Existing Zoning F imc,
City (,d,L u State
(include suite or - floor)
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- -------------------------- ------ esuite or -oo
PRIMARY CONTACT
Who should we call/write con ruing this project?
Address : City UQ> - State V Zi
Office Phon" �/ 7 � o11 # Fax # 7 7ti'-"CJ[.r DE -mail
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PROJECT INFORMATI ����%�
Business Name/Type: ion &i--�
Previous Business on this site:s_,l
Proposed use:
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 anew 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 =--I- Printed �� C� �c `z- y ci v�
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APPRRMATION
[ ] 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.
Building Official
Zoning Official '
Contact ACSA 977 -4511, x119.
Therefore, it is not a determination of compliance with the existing
. W6-j)4
Date
•
Date Cob
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