HomeMy WebLinkAboutCLE200800121 ApplicationApplication for
Zoning Clearance
"IHCf`t1
Zoning Clearance = $35
OFFICE USE ONLY i
CLE # IWO — I iI
PLEASE REVIEW ALL 3 SHEETS
Check # , ' `' Date: s'--z5'0
Receipt # '1(.�(D �I Staff:
PARCEL INFORMATION
Tax Map and Parcel: 6'/— / 3" Existing Zoning �� S
Parcel Owner: S-PoPPItu& CCA17E6 AT50Cr1-}'7"G- C St-PNoral Lo
Parcel Address: / ./rxo City C, l le State Vct-- Zip ��c7
(include suite or floor)
PRIMARY CONTACT _
Who should we call/write concerning this project? Y j` ®sC rlq
Address: / ,ILI/ 04-)C"Ay PLACC ME City L✓ jHT,/UC,7LNState C- Zips -CQ,
Office Phone: (2) 3qq 4va- Cell # �3 °�Zf �n�� Fax # "16.9E-mail W5 A-[ a) htS a'CoC -1
APPLICANT INFORMATION
Business Name /Type: N 'T e K 'P R 5 / Fr(. Z• ( 5 5 C- Lff S
Previous Business on this site D15 ti--E o N S 0, V A R C qA 4A LL
Describe the proposed business, including use, number of employees, number of shifts, available parking spaces and any
additional information that you can provide: °ier•tr' - ''c-k el'.y r✓ e s )
l`o 'i
Intake to complete the following:
❑ YES [VINO
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's RVil ER) packet.
❑ YES
Will there 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
❑ YES ❑ NO
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
❑ YES ❑ NO
Is parcel on septic or public sewer?
❑ YES ❑ NO
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
❑ YES 2 NO
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning Tech to complete the following:
Reviewer to complete t e following:
Square footage of Use:
YES ❑ 0
ermitted as: 1
Under Section: �Po
Supplementary regulations section:
Parking formula:
Required spaces:
❑ YES ❑ NO
Items to be verified in the field:
Inspector : Date:.
Notes:
Violations:
❑ YES ❑ NO
If so, List:
Proffers:
YES ❑ NO
If so, List:
Variance:
❑ YES F-1 NO
If so, List:
's:
❑ YES ❑ NO
If so, List:
5 /1/06 Page 3 of 3