HomeMy WebLinkAboutCLE201000082 Review Comments Zoning Clearance 2010-05-12honing_
Application fow* 7oning, Clearance
i
ningblea,rance
OMCE USE ONLY
Check # Date.*: (I"
PLEASE RE-VWW ALL 3 SHUETS
Receipt staff.
PARCEL INFORMATION
Tax Map and Parcel: —t77? —QZ) to 1�6 Existing Zoning
Parcel owner:
Parcel Address: t(Y� city, kAO Zipa2
?rjkiT711,K Rate'VA
(include suite or flop, 0
PRIMARYCONTACT
Who should we c0l/write concerning Viis projot? /4�y-e md h - �J,ZA 1, � /,'A (-AA/
Address. : A �OPIIL City State Zip
,
2 6
"PLICANTJNFOkMAMN
Check any thaCapi& 'h --'f" b!"p tis�ge ofuse.. Change of name : --busid
f t
..ame/Type: 2m6q/qIa.L HiA�g nI /1/il 1� K U' p` o-
A E
Previous lgusfnles-sou this .sitt
Describe the proposed business including use, dumV�rdf enioloy f shifts, available kin umber f
par g sp co �ro
Pmber
vehicles'.8nd , additional itionAl Information that you can provide; , p6m;� 1 V)O rXI
YU
*This; earance will only be }valid on the parcelfor ,
which myorin
j0jop C ame.w,i ocatior, a aew baing
"Y'
wne�,!�pe,�nms.6ton,Wi'usiD,.t e�space, I mon't Wce pro x
y ftf- "d6d
At 6 bav - A- 970�t4?4
�is, true and accurst cj: 'the diti6lis ... ... W and st d
O"A V _,' d I' & Jhem,iand
Signature Printed' c0 c�,�TT-
....... ...
APPROVAL"INFORMATION
propos pprqy Denied;
pproveal proposed`. ]Approved 'O&w�it,fi' " conditions 1, ons,
, ,. ' ' " ,
1 1tackflow,preveniion�devlce�nd/or,�irreni,iestdita'nmded:tor�tfis�ste' drtactACSA-977-4511 kII9.
,
" ..,
No p hysiaa I s4te nspeotion, h as been Amief& t is clearance, Therefore,. it is a determination, . of qqnp, ik'
site plain:,
J:This .i:sit complies '' the I"
Notes:
guild] g Offici I
Z'6nIng'6McW' Date,
7
.:other Official" . Date..
xf
ld�j
Intake to complete the following:
Reviewer to complete the following:
Y / 0 Square footage of Use: �j IL
Is use in LI, M or PDIP.'zoning?* If so..give appIicaiiV4 Certified
Engineer's Report (CER) packet. f7 N
KIrrnitted as;
Y frN
WM,"re be food preparation? Under Section:
if so, give applicant a Health Department form.
- re . view I ca . nno not begin until we receive approval from Health Siupplementary-Tegulationg section:
Dept. FAX DATE
Circle the one that applies Parking- formula:
0
Is parcel on private H -�H c
vate wej Ctublic water?
qter?
W:
If private well, provide : �nt fo)rm.
Zoning review can not begin until we receive approval from Health Required spaces:
Dept. FAX PATE
Circle the one that , I'
P
Is parcel on septic
'
Y (N
Wi {bepjtt,ing up a neW.si gn ofafiVkind?, if so;
Sign,permit
Permit #
YiI16)
Wift�e'be any, new construction or renovations?
'if so, obtain the proper Permit.
'Permit#
Y,
if
ttle-1011ow'I
—/7 7
Y /A
Iterhs-(o be verified in the field-
Notes:
lE so
— is
Data,
Revised 04/2,8 /08`Page 3 ',of 3