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HomeMy WebLinkAboutCLE200800029 Legacy Document 2013-01-03}' E'U/ 05 /2000 / TU3 11.23 AM Luck Stone Gir U4/ GVr -i0 UO. 4 r 41134z t J i JU 9�/01/7t3a2 00 :01 8042BB3096 - z.o v7 - t 7-7 7. A tv— FAX No.804591 2668 rHV 1L1UN • r-nurtrc 1 ..taZ) RATRTU ppficati � on for .tooting Clearance (3z"kzChM,Mat =sea 'X" — puL4 F, RLVI] W ,&LL 3 SHUTS cwk# is 'Fait ltd alad bWaAa P. 002 t'Aaat T.1 PAGE 62 SUM 0 rovel Addroul rip aaaairlt+■✓ AM ZIP is soke or flu-or) PRIMARY CONTACT USA �"ot- �r S Who niboteid ate e.stliirreitaa amtr6ara ft ibis pra�anct! _. _ .�-- --- .Address:. d9t I ° g —r-ity C. t n►. a°f sttai.. t,lak _ �_ _._ r✓ 09141, "Mme.- ) 5�,-� j°P 2 �idl{"tf o Cell v � Fax #t , 7� ' - w APPLICANT UWOR TION (t4,11,610.0 0"imafes 1�iss�Yps1 '' , Itavrriaay $maiei dM sa Ab Wb N Ofj or 4b,, tee pevepaoiamtl b>aa1nm,;AdQdide ase, 611MW Of aaa ltkAtael ilsia3s 9itast+ 15a►� en pf*vi&t lzls �` poet, kjol bar lit fhjft$y aeVaellaable part.' spatioaoa aw,oftl "Y /-.dY .S , 2L 5i-. r i�1 i'F,i? k, IV,16 °This Claare= will Daly be valid ao to VW* fst' which it is moved. if y alu 6M90, ijXWW* or offln &r. nw to a.,W& kuoatlaai; a now 2oa+N t 1twam a twill be Muind, 1 b"l;Y CA"4 toot 1 own orhavat tM 6 wmte'a pamuiseioa taw fire WA indiewd en alas appliomian, Y also erea�v due the infasa� ion paan►�d is true and a e Isdu of my kwwlcdpe, t Papua MW tbo Mdibons of apptm�vW,, ind l untiaraaufd *M. 4W aihaa I Wi[I AK40 t yM . YSiasu►ttn /� ~�, . - -- _ �.`.� krint:�." _ _�' €�+.1 1 t- ��hti'�nt a^ {� � � tw� , Ill' ()VA,L YN7FORMA'"ON ( U A 'ed aPnPowd l ) AWOV44 with ooaulit1045 i 1 Defied 1;yThrktlaw prow ntio n davi0o WNW current test data dewdod for this site Canted ACS & 977 4511, xl 9. I lea phylicW site imps c-49n has bmm alone for Oiis ala mace. lberetwo, it is not a detewmilw6an of col"P116 "with the existing $ks lt�4d. (j j Thil rte eomphea iibdws p tas of ah;aa aiaela5, l+Tattvdt- NM L y --. MARC I official rn1e� t�I19acArA1 &taro Mor official Ditto County of Allnenulls Depa rs anoni of cotaEmmakty toevelop,nuCat . at01 Ma'1[>atla'e'lawd earl+pt�wsvil9ay YA 2Z� �Vas6aze: 4�4.a�$) �9Q� -i�� 1Fax; (41�4j 9?� -/i26 9il/H Pap 3 of 3 '01;,01/2002 00:01 8042883066 Flotake to complete the following; 0 YES [:1 NO la use in UZ H,I or PDIP zoning? if so, give applicant a Certified Engineer's Report (Chit) packet [] YES 'No Will there Abod Preparation! If so, give applicant a Health Deparftne it form. Zoning review can not begin until we receive approval from I3lealth Dept. FAX DA'C'E [7 YES a NO is parcel on private well or JkUl P- If private vvell, provide Health )Cigxuunent form. Zoning review can not begin wttil we receive approval from Health Deft, FAX DATE R lTS I NO ,-- Is parcel. on septic public sewer. (] YES () NO Will you be, }gutting up a new sign of any kind? If so, obtain proper Sign permit. Permit # 0 YES ® NO Will there be any new consttuc ion or rea(wations? If so, obtain the proper Pemit. Permit # X07 - 1 272..E t- i!,oning `l'ecb to complete the following.* Violations: [] YES NO If so, List: Vxe9srtce� 0 YES ❑ NO If so, List: PATRIOT LUL.V-STtP8L — Reviewer to complete the followiing: PAGE 03 squareeff otage of Use: _ -W7 YES © NO Permitted as: e• Under Section: Suppieanentary lations season: �._ MIT _..� Parking for�tl{i {I / .Required •y�(�y.. - - -- E;S No.J ltems to be verified in the fiOld: ,Inspector ..- Dat+e:. 'Notes: — -.- --- ---- -- 511106 Page 3 of 3