HomeMy WebLinkAboutCLE200800114 Legacy Document 2013-01-16a
Ap ,1ication for Zoning Clearance
CLE #
OFFICE US3E3 ONLY,
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PARCEL INFORMATION
Tax Map and Parcel: �' Existing Zoning
Parcel Owner: �� Woo a
Parcel Address: S V 1 h! � )le- ✓ Z, City e Q--
Zi
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project?
Address : SGi_YYl e-- City
Office Phone: " oncell f 3 #
APPLICANT INFORMATION
Business Name /Type:
Previous Business on this site
Describe the proposed business including use, number of empl
vgWcles, and any additignai\informatiop,that you can provide:
DV ,e P5 r 5
re4i 7oWy l�asv�
number of shifts, available parAing spaces, number,
*This Clearance will only be valid on the parcel for which it is approved. If you change, intensify or move the use to a new location, a new Zoning
Clearance will be required.
I hereby certify th own or have the owner' ermission to use the space indicated on this application. I also certify that the information provided
is true and acpur o the best of my know dge.g, �4yA fead the conditions of approval, and I understand them, and that I will abide by them.
Signature l;f/�'l /�! / i� 7L-7 � Printed `, a-U,Ie
APPROVAL INFORMATION ` V '
[ ] Approved as" proposed, [ : ]Approved,.with conditions
[ ] Backflow prevention device and /or current test data needed for this site: Co
[ ] No physical ''site inspection has been done for this clearance. Therefore, it is
site plan.
[ ] This site complies with the site plan as of this ate.
Notes: Uy'!p/G�- ,/lkt.GT/LC.Q:Q �14 -
it a determination of complian i rile existi l