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HomeMy WebLinkAboutCLE200700114 Legacy Document 2013-12-12Application for Zoning Clearance nrtr, OFFICE USE ONLY Zoning Clearance = $35 CLE # Gr)(D 7 . PLEASE REVIEW ALL 3 SHEETS Check # mr:) 3 Date: - C7 -7 Receipt # Staff: ' PARCEL INFORMATION Tax Map and Parcel: OS(,p T / '00 'OV 06 20 Existing Parcel Owner: v�{%�� 41— GGoAWK Z- ,'W__W/� '' // Parcel Address: � &9W GHNe- � % City (� /� / /(,(.� State Vt Zip v^ (include suite or floor) PRIMARY CONTACT � 1 Who should we call/write concerning this project? g� '" - Address City State Vd}- Zip Office Phone: Cell # gai Intake to complete the following: ❑ YES NO Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. ❑ YES ENO 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 kf is water. If private well, provide Hea h Depa ent form. Zoning review can not begin we receive approval from Health Dept. FAX DATE F-1 YES F-1 NO Is parcel on septic o lic sewer. ❑ YES ©' NO Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ©''YES ❑ NO Will there be any new construction or renovations? If so, obtai the proper Perim. Permit Reviewer to complete the following: Square footage of Use: D Q YES ❑ NO Permitted as: y Q &e� Under Section: b M �. Supplementary redulations section: Parking formula: Required spaces: YES ❑ NO I ems to be verified in the field: Inspector : Date: Notes: Zoning Tech to complete the following: / Violations: ❑ YES If so, List: F-1 NO 4 I Pro ers: �2 YES ❑ NO If so, List: / Variance: ❑ YES If so, List: ❑ NO SP'� ❑ YES ❑ NO If so, t: 511106 Page 3 of 3 Q Frpr 23 2007 10:07RM HP LRSERJET FNX P.1 �iJ ;: � D i iii � iii i � i �i .: �. �o �► � � Eb r• 0 0�. f� r #105 94b r7..�.8 1690.x-. S. F. ���7 PosWV, Note 7671 Date #ges To From Co. /Dept 00, Phone # Phone N Fax # m m #105 1690.4 S.F. ■■ 1 41 a X106 737.8 S.F. C n