HomeMy WebLinkAboutCLE201200174 Legacy Document 2013-02-1908/14/2012 01:15 8724310
#5883 P.001/003
Application for Zoni Clearance
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OFFICV, USE y
PLEASE REVIIEW ALL 3 SHUT'S
Choqk Date:
Rdeelpt b T_;5_45� stAm. d f)
PARCEL INFORMATION tmnrlec o.evajopmom
TRX 9RI) AtId PAI•II: •PM; ExIstbag zoptil,LY.Sh(jp.plOo.::Co'ntEi'r .
,'Ri*o As8oddes Umitgd R4rfnurshiV C /0. Dumbarton'PropQrtbas
Porcei Owner,
Pni-celAddress; 100A1b0tnefr1e*5qu*are, cjty.. iN d ottetivll 1'b st'R to VA xip V2.901
(Incluat suite or,1109r)
FRDIARY CONTACT Ginm� Freyeldenhavon
Who amad we ann/mito cone.orning this prolert?
N. Qfosri.e.Zt.S.U:Ito N.0 X7'3'01 zip 33,6_2y_a� . 0101 * i
omcq Photo; (11-1., Cell Fax.#
APPLICANT WORMATION
-Check -Any-th t-apply_-- Clifinge-drovvn'ership----Chaijgebfli9e— _Chan go-ofimme 6USLOM-
Thdfresh Wrket!.G.'racary Stofe;
provtqlm RU41noms on this. site
Dei&ribe tj.ie ptopOf6d t1iiin6as inddlg usel'iiiamber of 8nip)Qyeasj laaa bvr 6f shifts, spaces, muniber of
?m,
P V
F14.�166 p og. Appr9?.(V.,Q e e U Ort fi,* ra.-t6ut .1� 0.5
We run- a varletv,of shifts-dotated,bv the sa,1p-s..,vqfqm.0& Parking•s.ga�es.aval�at�yai.s: 1'4'T
*Thla CImance YVUL.onlY ba mild Qn. tho parcel for w446 it is TCY9V 00M, iA FMOY 4 zkQY!P t110 AJZO tQ 0 nclv'1906pn, a 40W.&W9
T haic'e6y cetil ry (114L1 QWor 11GY6 iie t6vac &c 4p'am_'Bd1c*d on this applicatiori. I alAo q;jt'6-.tfj d the in'(011-mlon PY0%;jdad
jx.jruq* end -A 'o d)Q bc3t ofxriy ] ndtvlo gc. 7 hevc fcmd. tl -pbiiditiohe dfa rdyal, And T'p oratsn[d 664.,`iihd lUt I Wi 11 -abide by1hU6.
.42PROVAL EVOILMATION
>4 Aog.b%ed �35 py0pbsed [ ] Appravc4 with aon4iliom
C 4Eqlftlow.preyqakr dcyic,t a0lor Oul'letil aqr de
dfuth is
IT116refpj-b, iris`h6t d',d.etevm1heqjUn of cotpliarwe Wilhill-0 c;Ya§d.fq
nice plat~.
Thksho comoiem w1ilAhe ilieplan as ofthle dato.
Now"
th
/ IQ.QP*0,0! Acrall.61011t P.P"P.Qmmil'afty D&.01911)WIt /
401 Mc -(45
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08/14/2012 01:18 8724310
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##5883 P.002 /003
Tnfeke to complete the following;
Reviewer to complete the following:
Y / N
Squarefoofteofuse: IQ /�5
Ts jia 1.1, III or• PDTP :coning? TYso, give gppl!cant a•Cerkifrod
Bngineei'a Report (CER) paekc
tmNlued Q �i-}5 ✓�'
os: f �a -
'Y' / TT
Will there be food prepm ation?
Under Section: a �i •'Z •�
If so, give applicant a TTealth Dej�ot•lmen( form,
Zoning review can not begin U11111 we receive approval from Heeltb
S Lipp lamantaq regulations scctio.n.
Dept. FA,XDATE — 44VIA- =
Circle the one that appli
Perking formula:
Is parcel obi privotto
if private tvcll, provide IloalthDopartmcnt farm..
Zoning review can not begin until tiye )Delve gtppl'ovnl from health
Requited spaces:
Deipt. FAX DATE
Y/N
Circle the one thatt 90&
Ttame to be v4ifled in thr; field:
Is pgreel bn ,Kptl'c or t� rb gr�•7
':YIN
VIII you be putting up •n nmY ugn of.¢rly ki nd? If so, obtain prop4j,
-- —
Sign ➢ergot.
Yermtlt# -
Inspector
Y / N 1Votrg;
Will zherp be any now vQ=iruvtion or r aaYaJlpns7
ifao,.'obi: j41!he.Ploopr,Permit•,
1Pat•tiilt#
rr—r,.•,. J.- 1L-
Violatiom,
lEso; LC &4�• � / /�
b Lam'
Pyo'M m,
Y l
If st:
Y
JPso, List:
/N
f stli List
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C. 10014066;
SI]P's
Re0sed 7/1/20.1 I •Poe& 3 :of 3
08/14/2012 01:16 8724310
f.
#5883 P.003/003
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS SEEN PROVIDED TO THE LANDOWNER
7'lais form Hurst accorij)wly zonitrg appiicalions (Horde Occupation, 2ou1jrg Clem -vice, 2'orrirrg
Ar lmiltistratoi- Deter,rotrrrations or,Appeals, !strot the
•aipnen
1 certify that notice of the application,hlh� �[ert1C9
[County applicatiop name and 1wrnbei]
was provided to Rla A-s,,a:d'et01_j'M1fe&.P, 1r).erWp .lie owner of record pf TAX mop
[nar-ne(s) of tliv record owners of the pareel]
and Parcel Number -GRINO 66.1 pA-pA b &- 1230,6. by delivering a copy of the application in the
xbora* identified below:
Hand delivering a copy of thr, appiication'to
[NAMe of the i'epord own.Ar if the,i-edgd• oWnvg is Q
person; !Hie owner of record is an entity,, identify the•reciplenf of the rrgoM and ch recipienr
title or offim for that entityj
dry
Date
' Mailing a copy ofthe application to �I,'l�tkiii
[Name of ilia record ownerlf the record owner is a•pers,on;'
it the owwer o1?recol)d is an entity,, identify the recipient ofthe record and .the reoiplent'e title or
:oi$oe forihat.entity]
gty'Augu,�t'Z,0.1: 9a,tl� fdlowt addlesa
Data
Orrxe4'5 Rlghmarjd, V&P -3.k&
.[adddt=; written notice mailed to* the owner at fire last known address• of 'the owner as. shown on
the carrom meal estate tax asses'smont books -or cprrentr'eal estate tatcassessmentrecords satisfies
US L'egljii'e�edt].
' Signatti of Applicant '
P.i�i'itt A�ii�igdi�t 1`I$I?1e