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HomeMy WebLinkAboutCLE200800061 Legacy Document 2013-01-11Application for Zoning Clearance Zoning Clearance = $35 OFFICE USE ONLY / CLE # i O PLEASE REVIEW ALL 3 SHEETS Check # Date: Receipt # Staff: PARCEL INFORMATION Tax Map and Parcel: 67& d © — OL) -� `0 J IWO. Existing Zon ji C 0 Parcel Owner: y ii" i h i Intake to complete the following: ❑ YES f-1 NO Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. r—ryES ❑ NO Will there be food preparation? If so, give applicant a Health De artmer form. Zoning review can not anti we r eive approval from Health Dept. FAX DATE 2'7 ( $ [YES ❑ O Is parcel on private well or _E Liblic water? If private well, provide Health Department form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE [YES ❑ NO Is parcel on septic or public sewer? ❑ YES ErNO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ❑ YES R'NNO Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Zoning Tech to complete the following: Reviewer to complete the following: Square footage of Use: BYES ❑ NO Permitted as: I ��Y OVt Under Section:3. to or Supplementary regulations section: Parking formal A^ n ^ � �� G-Cz� b� +V UP-"P—' Required spat ' 9,V ❑ YES \ NO Items to be verified in the field: Inspector : Date: Notes: Violations: ❑ YES dNO If so, List: Proffers: ❑ YES ❑/O If so, List: Variance: ❑ YES VNO If so, List: SP's: ❑YES D�NO If so, List: 5/1/06 Page 3 of