HomeMy WebLinkAboutCLE200800030 Legacy Document 2013-01-0302/05/2008 TUB 12:'00 FAX 4343271896 2002/002
02/04/2008 04 :27 4342973755 PAVILION PROPERTIES PAGE 02
UU. ua wk ggzb 4uob PATRID— PAGE 04
Applicati ®n for
Zoning Clearance
0YA41e8 i'f"w"te -Sae
PLEASE RE'VIEw ALL 3 9REETS
.— Llieft
i oaraer: tt t d P 4k S t 4.4____
J'aerKet Aaldrers: bxtt -ar✓ m+zw o C v '�t"tt�'i LYc� ��str� ✓!�� Z �1 j
( do or Doe)
PMMARX CONTACT
Who mid wE nw w�rw 0"Mx ming Ahis projett* Lis o, - "ts w err
C9fwtihowtLEj �(�3 -J�'a CritN —FAy ��V- �9i•87 Td'pi�� �i w!
APPLICANT INFOYtWCION (CtLJwwr,14)
Husbm" Naffi")Ve
Pftvim Dwietew on dds Ata
t�svetC Plc,� S�C�t'o�
Desaibs the prOOMW b0liaserse. includiall un, name.ber otseemplaryaes, tjurylbaGr of 0%1114, evAlls letp ►letg spares aad miry
#ddb +sd i�S� : ptr6► ls: ___ _ � R txmev. A F%i4:7 -11n •e- a Ce�x7 a t�
"Tide G9eesaooa wit! only Dc vaAadas 141e i►�tal far which it is �ytv��a�: tl'tvtia change, ttttmt.eriSy x,00vo � uae to u s�ev 9s.�catinA., r nc� Zcataitpt
Clommo a wiU he smutted
X haahyrarti y shat I esw or bays tba "zees peettl'losioa to use Iko vpwr Mcasbd on chili %p iaa4aa_ I also cei* mi r tic Raf'ormn on pm vided
is tmasiad +cpttsow to dae beet of my kraowtedgp. Z i nc reed 11M aaadttions a mpproFa(' d 1 Mda%wad them, psd fti r V& abide by thorn.
si era"e G- &tom -c�J
APPROVAL INFORMATION
C I Appramd As pcoWwd I I Apixoreed meh onditions [ 1 IAeded
[ ) %rk&w peevtmtion device and/or amvri W daft needed for this slit.' Comet A CSA, 971 -4511, xl 19.
( I No pbVsiW site ispaotion teat bw dome for t;sis clamro. l7 wdon, it is wt a detamiwdonew4vVliwte with a Heisting
sae plus,
( I This site tamnph s w>itb ft aik pim as oftbis dace,
Now:
Building offlc6ai Dote
ZoAiag oftul Dote � c�
Cltfisr 011iein6 - -- - Dow
-County at AXbomade Department of Commsustity Dtvclopwoat
401 Mclatire load CberiotteovilK VA 72M Voleet (mod) 206.5 Z Fat- (434) 02.4126
53106 ho2of3
.Gt f
tp1 r 01 J 2x_!0'2 00: 01 8042883066
PATRIOT
PAGE 05
Intake to complete the following:
❑YES (❑:ho
is use m i.J., 1-11 or PD)P zoning? 1f su, s,ive. applicarn a C:ertif3eci
Engineer's Report (C ER) packet
❑ YES �z No
Will there be food preparation"
if 3o, give apl hcant a Health Department form.
l.oiiin.g review can not begin until we recetvc approvai from 14.e.a.I0)
Dept. FAX DATE ..... ... _ . _ _...
Is parcel on private well 0 u;1i c. %eater"
if private well, provide lien t. wart for n.
Zoning revietiv can not begir, until we re eive approval from Health.
Dept. FAX DA'i'1":
YES g NO
is parce) on septic c� public sew
11
[� YES P NO
til� ill ��ou 6e f +uttlit� ul) e� rtew si�;si of'any kn,cl'.' lt'SO, ohtttii7 )�l-aper
Sign permit
Permit #
X YES ❑ N O
ll there be any new construction or renovations"
if so, obtain the proper flemlit
P €rmit #. f7 [7 "?.'....1 to t
Zoning Tech t9/complete � the follow
Violations:
❑YkS ZI NO
fl, so, 1.,i5t
❑ YES+ 0 :()
If so, l..ist
Reviewer to complete etthe jfollowing.:
Square. 1aotage of Use
Kt
�.! V V17"
i
i
Uodar Section _
Supplementary regu aiions SWtiorl.
Parkin. fon..- • - - -�- — - — - --
i
I . Kc�quired spaces:
Items to he verified in the field.:
If so 1.,!st
sp'st
I(sa, t.sst.
Sit:Q(j E�i1pSt� pl� j