HomeMy WebLinkAboutCLE201500246 Application 2015-12-01Application for Zoning Clearance
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CLE # 1 � — � `i6
OFFICE USE ONLY .� 1� ���
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PLEASE REVIEW ALL 3 SHEETS
Check # Date:
Receipt # Staff:
PARCEL INFORMATION G
45-68C1
Tax Map and Parcel: Existing Zoning
Parcel Owner: B Properties LC
Parcel Address: 2070 Seminole Trail City Charlottesville State VA Zip 22901
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? Scott Lancey
Address :1545 Shady Forest Way City Charlottesville State VA Zip 22901
Office Phone:4( 34) 964-0880 Cell # 540-461-2171 Fax # 540-943-6676 E-mail scott.lancey@scouting.org
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name/Type: Boy Scouts of America/Won-Profit Youth Organization
Previous Business on this site
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
vehicles, and any additional information that you can provide:
*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.
Signature Printed Scott M. Lancey
APPROVAL INFORMATION
'[].Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, xl 17.
[ ] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing
site plan.
[ ] This site complies with the site plan as of this date.
Notes:
Building Official Date _ d
Zoning Official- Dated'�z�P%
Other Official Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126
Revised 11/02/2015 Page 2 of