HomeMy WebLinkAboutCLE201800214 Application 2018-10-12Intake to complete the following:
Yj / N
s use i LI )HI or PDIP zoning? If so, give applicant a Certified
Engineers Report (CER) packet.
Y /�N j
Will t ere be food preparation?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from Health
Dept, FAX DATE
Circle the on lks
Is parcel o private well r public water?
If private we prove e Health Department form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the o t applies
Is parcel o septic r public sewer?
Y
Wil ou be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
YC
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning to complete the following:
Reviewer to complete the following:
Square footage of Use: �opc) ,
Y / Nt
Permitted as:�n�WV (aZk—'
Under Section:
� r
Supplementary regulations section:
Parking formula:
Required spaces:
Items to be verified in the field:
Inspector: Date:
f
Viol �o s:
Y /
If so, ist:
Prof rs:
Y/N
If so, ist:
Variance:
Y/
If sst:
SP's:
If
YAIM-
Clearances:
SDP's
Revised 11/1/2015 Page 3 of 3
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the
owner.
I certify that notice of the application,
was provided to
[County application name and number]
[name(s) of the record owners of the parcel]
and Parcel Number
manner identified below:
Hand delivering a copy of the application to
the owner of record of Tax Map
by delivering a copy of the application in the
[Name of the record owner if the record owner is a
person; if the owner of record is an entity, identify the recipient of the record and the recipient's
title or office for that entity]
on
Date
Mailing a copy of the application to
[Name of the record owner if the record owner is a person;
if the owner of record is an entity, identify the recipient of the record and the recipient's title or
office for that entity]
on
Date
to the following address:
[address; written notice mailed to the owner at the last known address of the owner as shown on
the current real estate tax assessment books or current real estate tax assessment records satisfies
this requirement].
LL
Signature of Applicant
I LL ►Va,,n :E, A ► i'L
Print Applicant Name
I V /4`' -Z 0 19
Date