HomeMy WebLinkAboutCLE201000077 Review Comments Zoning Clearance 2010-05-17Application for Zoning Clearance
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CLE #
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❑ Zoning Clearance = $35
OFFICE USE NLY
Check # Date: -
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PLEASE RFVTEW ALT. 3 SHEETS
Receipt# � Staff. ,Y� _1:0tt'Pr'
PARCEL INFORMATION
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Tax Map and Parcel: p(p i ()b 00 0o i1a3 Existing Zoning
Parcel Owner:
Sew� � �jA C� I Parcel Address: $. city tate Zip
(include suite or floor)
PRIMARY CONTACT
/write
Who should we call concerning this project?
Address: Fl-W SZwI.l1ol, -Ti" k SyiTC lb5City 0-j, &rI ,& -e- t((-State \1A Zip 9PLq 0 I
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Office ]lone:('i
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Intake to complete the following:
Reviewer to complete the following:
Y /
Square footage of Use:
Is us Vin LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y)/ N
1
�ermitted as: �G �i 5
Will tITere be food preparation?
Under Section:
if so, give applicant a Health Department form.
'Zoning review can not begin until we receive approval from Health
Supplementary regulations section:
Dept. FAX DATE
Circle the one that applies
Is parcel on private well or blic wat
Parkin formula:
r
If private well, provide Health Department form.
Zoning review can not begin until we receive approval from Health
Required spaces:
Dept. FAX DATE
Y/N
Circle the one that appl'
Item be verified in the field:
Is parcel on septic or blie sewer
Y/N
s
ds
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Inspector : Date:
Y / N
Notes:
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning to complete the following:
Violations:
Y /
If so, List:
Proff rs:
Y /
If so, ist:
Vari ice:
Y //N
If so; st:
's:
If so, List:
n
Clearances:
s
ds
Revised 04/28/08, 10/13/09 Page 3 of 3