HomeMy WebLinkAboutCLE201900021 Application 2019-03-07Intake to complete the following:
Y
Is u LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y/N
11 e 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 one that applies
Is parcel on private well o public wat
If private well, provide He et form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that ap
Is parcel on septic r public sewer?
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y/N
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: 9600
/ N
-witted as: (Q,)
Under Section: __i71I. ON}}t1a
4-0
i
Supplementary regulations section: �
Parking formula:
� Ism KEA—
Required spaces:
Y N
Ite to be verified in the field:
Inspector Date:
Notes:
Vio io s:
Y/N
If ist:
Pr ers:
Y/N
if so, isv
Va an e:
Yso, i/N
I st:
SP,s
Y/,
If so, ist:
Clearances:
SDP's J1
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Revised I l/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, Zoning Clearance
[County application name and number]
was provided to CANOPY CHARLOTTESVILLE LLC the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number 07900-00-00-004NO by delivering a copy of the application in the
manner identified below:
0 Hand delivering 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
and E-mail
0 Mailing a copy of the application to CANOPY CHARLOTTESVILLE LLC/ JOHN BURKE
[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] Senior VP. Commercial Leasing
on January 31, 2019 to the following address:
Date
83-85 RAILROAD STREET SARATOGA SPRINGS NY, 12866 / john.burke@goprimegroup.com
[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].
SignaiKure of Applicant
Clayman Edwards
Print Applicant Name
2/4/2019
Date