HomeMy WebLinkAboutCLE200800175 Legacy Document 2013-02-19ceq )K
Application for Zo '
CLE #ln C'learance
� or• n
Intake to complete the following:
Y/N
Is I, HI or PDIP zoning?
Engineer's Report (CER packet. so, give applicant a Certified
(� )packet.
Y fit'
W� e be food preparation?
If so, give applicant a Health Department form.
Zoning review can not begin until
Dept. FAX DATE we receive approval from Health
Circle the one that applies
Is parcel on private well or, ublic water?
If private well, provide Health Department form.
Zoning review can not begin
Dept. FAX DATE until we receive approval from Health
Circle the one that applies
Is parcel on septic or public sewer?
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y/N
Will there be any new construction or renovations?
If so, obtai the ro r P
Permit#
boning to complete the_
Violat' is:
Y /
If so, ist:
VaEii e:
Y
If st:
Cleara nces:
Reviewer to complete the following:
Square footage of Use jk)
[Parking N fl mitted as: der Section: plementary regulatio s section:
formula: ired spaces:
N 4A
Items to be verified in the field:
Inspector:
Date:
Notes:
ly/N
I so, List:
.Vs / N
o, ist: , /�t/L
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SDP's
41 (v
&g 13A Revised 04/28/08 Page 3 of 3