HomeMy WebLinkAboutCLE200800145 Legacy Document 2013-01-17JUN-17-2008(TUE) 23:25 Sara (FAX)330 666 8338 P. 002/008
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Application for Zoning Clearance
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(baclude multo or floor)
PRD4ARY CONTACT
Addremy city state
Can # Pax
APPLICANT INFORMATION
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Previous Busivelo on thig site
Describe the proposed busineso Including use, number of ble pmrkNg spaces, number of
vehiclu, and any additional information that you can provide
*This Clearance will only be valid on the parcel for which It Is approved. if you ohange, intensify or move $e use to anew looation, anew Zoning
Clearance will be required.
I bcruby cl tbat,l own or havc tbo ownces pGrminsion to uso thr 5pacc indicubud on Us application. I also certify that the Information provided
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Is tr — Tc o The best of my knowled ave read the condhions of approval, and I understand thern., and th&r I will abide by them.
Signatur Printed
Nat
401 McfAtire Road Charlofteovige, VA 22902 Voice: (434) 296-583Z Fax; (434) 972-4U6
Revised O4/JQ/O0 Page Jof3
JUN- 17- 2008(TUE) 23;25 Sara
Intake to complete the following:
Y /®
Is use in LT, Hi or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y /QWill ore be food proparation?
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 rve71 or ttlbddc evater`?
If private well, provide Health epartment form.
Zoning review can not begin until we receive approval from Health
Dept, FAX DATE
Circle the one that ap�Oewmr? li
To parcel on septle or
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y' N
gil0 l there be any new construction or renovations?
If so, obtain the pro .er Permit,
1Permit# 2-OD F "4C—
Zoning to coxuplete the following.,
(FAX)330 666 8336 P.003 /00x1
fewer to complete the following:
Square footage of Use: _ �!h() ? Y
0 ermitted as;
Under Section: 2-5.
Supplementary regulations section:
Perking formula:
r O
Required spaces:
Y 11N-)
Items to be verified In tho field:
Inspector t Dane:
Not":
VIDIations:
YIrN
If so, ist:
'Ptroff :
Y /V
If so, List:
Varblice:
Y to
If so, List:
I9P'ar
/YD/ N
f so, List:
Cloarawces:
Revised 04/28/08 Page 3 of 3