HomeMy WebLinkAboutCLE200900134 Review Comments Zoning Clearance 2009-08-31Application fo mnin - lear ncc --
OFFIC1t USE ONLY
Clearane = $3§ p oq Zonig �
PLEA E REVIEW ALL 3 SHEETS Receipt # Staff: � r(
PARCEL INFORMATION
Tax Map and Parcel: (,` 51 -®() .e "d t /� Existing zoning l ,
Parcel Address. 195'KNV RB6/f,1 �} CSty
(include suite or floor). SUIT
Who should we call/write conceroiti this project ?�(
- Address.• jq 1 1Y� 2.i1�71Z City'
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Office Phone: & b _ •_Lg- l ` Cell # It [ - 9M( ,Fax #
l4ti Y e CU/t
Clearance will be required.
I hereby erti that 1 own or have thepwner's
y ' pennrssion to use the space indicated on this applicatian- l also certify that the information provided .
is true and accurate to the hest 4 my knowledge. l have read the conditions of approval, and I understand the, m, and that I will abide by them-
Signature, ted�
APPROVAL INFORMATION
Approved as proposed [ ] Approved With'conditions [ } Denied
[ ) Backtlow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, X119".
[ ) Nophysical site inspection has been done. for this clearance. Therefore, itis not a determination ofcompliance with the;existing
site plan.
[ ) This site complies with th0ite plats as of this date.,
.Revised 04128/08 Page 2 of3