HomeMy WebLinkAboutCLE201300143 Legacy Document 2013-07-29Application plic,ation fog Zoning Clearance
11
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CLE # 2U I3' 14-��
OFFIC'.E TJS , O Y
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PLEASE REVIE V ALL 3 SHEETS
CI►eck — �, 7��— Date:
Receipt -� Staff: J
PARCEL INFORA -I_ TION
Tat Map and Parcel: I -- 0lz�(Q Etistiug Zoni►►g
s
tA allfflt Ud F14�
Parcel Owner:
I
City State Zip Z �
Parcel Address: - ? b `•o r l
rte�
(include suite or floor)
PRINLARI' CONTACT --�
11-1 ►o should we call4rite concerning this project? �1)��
Address '� ,x_�i _y� Cit-y- 14/9.�'�,✓"14 -' State 1 Zip
: c--�J
Office Phone: L� Cell =.�j'` 0(40 � Fax--A'
Intake to complete the following:
Y ON
Is use in LL HI or PDIP zoning? If so, give applicant a. Certified
Engineer': Report (CER) packet.
Y 0
Will there be food preparation"
If so, give applicant a Health Depat-timent form.
Zoning review caii not begin until we receive approval fi•om Health
Dept. FAX DATE
Circle the one that applies - -�
Is parcel on private well oi` gn lic n ^iter?'
If private well, provide Health Department form.
Zoning review. call not begin until we receive approval fi•oin Health
Dept. FAX DATE
Circle the one that applies
Is parcel oil septic ok rnblic se`i-er
Y / N
ill you be putting up a mew sign ofiiany kind? If so, obtain proper
Sign peiniit. (Y,vt-�f7' q-jy1?)
Pffmit.
Y ,C
l ill there be any new construction or renal ations?
If so, obtain the proper Permit.
Permit 1
Zoning to comWete the following:
Reviewer to complete the following:
3�
�CS�\cpiei•e
/ N j�
Pernitted as: b 5; L5!5 6 (�
Under Section: 22 .2.,
Supplementvy regulations section:
Parking formula:
Required spaces:
Y/
Items to be verified in the field:
Lispeetor : Date:
Notes:
Violations:
Y /
Ifsobist:
Proffers:
Y 1
Ifs ist:
Vari'Ace.:
1
If so, List:
SP's-.
If sOpist:
Clen :uices.
SDP's
Revised 7/1/2011 Page 3 of 3
CERTIFICATION TILIT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
Thisfoy7n must. (tccornpony zoning al)I.Y cations (Howe Occig)rition, Zoning Clearance, Zoning
A orAppeais, S'i,n Pemiks, Buiteling Per7i ►.ift) rf the qlWeadon is, not tile
owner.
I certify that notice of the application,
[County application name and number]
was provided to
[name(s) of the record owners of the parcel]
the owner of record of Tax Nlap
and Parcel Number _ IQ '?� ( by delivering a copy of the application in the
manner identified beloi��:
Hand delivering a copy of the application to
[Name of the record owner if tile. record owner is a
person; if the owner of record is an entity, identify the recipient of the record and the recipient's
title or office for that entity]
W
Date
Mailing a copy of the application to
[Name of the record owner if the record o«nier is a. person;
if the owner of record is an entity, identify the recipient of the record and the recipient's title or
office for that entity]
Oil
Date
to the following address:
[address; written notice mailed to the owner at. the last known address of the owner as shovm oil
the current real estate tax assessment books or current real estate tax assessment records satisfies
this requirement]. .
SiX ature of Applicane'--'
JV4 kl--+,-,o
Pruit. Ap ant Name
G -0
e
I I I
............ ..
2668
5'-0"
2668
2668
--- -------------
....... .....
..--- ..- ._........10' -0"
7
6"
3'-1 1/4"
P qRl
5040 6066 1640
6' -0" T-8 1/2"
LIVING AREA
5'-0' 19,_2° -------- - - -
24'-2"
LO
zo
2z
C?
zo
--- -------------
....... .....
5040 6066 1640
6' -0" T-8 1/2"
LIVING AREA
5'-0' 19,_2° -------- - - -
24'-2"
LO
zo
2z
C?
zo