HomeMy WebLinkAboutCLE200800119 Legacy Document 2013-01-16F
Application for Zoni g Clearance
is CLE # °� - 9 '— i 1
PARCEL INFORMATION 1-° A-"L" // U 1 " } 1 ► �}�
Tax Map and Parcel: ` 1.� n� 7 ' Existing Zoning Si �t C--Q I W )
Parcel Owner: G
Parcel Address: LIT)G45�G l <<lrloui ""City VlC1-I-JG QStateZip 2-2-911
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? c� +r
Address: `7 I��S� C La I I C)Lj Li City 01
VLJ Zip
Office Phone: ( %%o -6S COI # .4J f% Fax # 11014 E -mail
Describe the proposed business including use, number of employees, number of shifts, avail ble parking spaces, number of
vehicles, and any additional information that you can provide: A) Lit 'J/
5,e If - e—yko �Ad
*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.
Intake to complete the following:
Is /
Is u m LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y/N
Will ere be food preparation?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applies
Is parcel on private well or public water?
If private well, provide Health Department form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applies
Is parcel on septic or public sewer?
Y
Will be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Willi �t Vere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning to comDlete the followinLy:
Reviewer to complete the following:
Square footage of Use:
Y/N
Permitted as:
Under Section:
Supplementary regulations section:
Parking formula:
Required spaces:
Y/N
Items to be verified in the field:
Inspector•
Notes:
Date:
Violations:
Y/N
If so, List:
Proffers:
Y/N
If so, List:
Variance:
Y/N
If so, List:
SP's:
Y/N
If so, List:
Clearances:
SDP's
Revised 04/28/08 Page 3 of 3