Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutCLE200700263 Legacy Document 2014-04-28Application for
Zoning Clearance
OMIRIT14USE bNIN
PLEASE RE, VIE A I. L 3stirm, T$ elleekil i!s 197 j);tto,
Receipt 81 a f 1--.
PrMCM, INFORNMTION 4>28 00 — 60 0
uY)nt N1411) wid Prim-l-
10-mul
Alx!lo�t, LLC-
do.*tv r 0,0r)
PRIMARY CON-TA(7
Whoslimild lye
Addreks: i KAU
lty t ate'
A.P.P1,1CANT INFO) NUTION'
131'(Sijja� VICA":dt -,Wem t
Ap-
beAl4rl tA
Vi-61ous Bimness on t p
—p
Describe Oie
tivailable .1mi-king, s 1 1015 111il :111Y
s
'I'Mis Qliarai(ee will opl.:b valid militc,pa
4. reel rbrWhich"
'Clearance %<ifi 13C -millfred.
Him-bycgutify that lowilur havc(lic mvilm'spull, wiss , iolvtu U-4 illeI)ate idn' I ako uMiryllf.'Ii
i", trila-311daceurilp to fitc lmslw-e illy wmyfv 1hd theu), in • pi-0411 afal I iindurst, d that 1-will alATIV, fly Owl.
PAItc
.u'j1.'x:1, %OvAL 5AT]ON,
Approved as proposed liti 1)6iiad-
dm* and/br tumdril cstdlita; needed for ihisr sito�. tontacv-AUSA 977�15.0 AIM
fAdl 10 llhy-iickl;silc Jm 30.0on:10; Lw.n d()ri4:,fbr t'hi :61, autm.'rhereromi it i, nota dk gi 11.
site plant,
.Cblj) 11 t1u sitcp!wvvis at, fl.tis dntp-
........... ..
D.110
011ie)- Official
D.11te
County, of. "anw1unk Y.1) e 6v 6 molft
, I 1
40i NIchitire Rand Char otter
ilk, VA2290211016 }296 n -2 T,nxi (4-340 14;116.
51406 Pow"? Or.3
,< 0 r—,-v
Intake to com ete the following:
❑ YES NO
Is use in LI, III or PDIP zoning? If so, give applicant a Certified
Engineer's Rep (CFR) packet.
[:3 YES 7NO
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
ES ❑ NO
I ar n private well or bl�Watmea private ell, provide Hcal t form.
Zoning re 'ew can not begin until we receive approval from Health
Dept. ATE! _
YES ❑ NO
Is parcel on septic or Ct:se:w�
YES [-1 NO
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit # kL C_
❑ YP,S NO
Will then: be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Tech to
A ■ •
Variance:
[I YES ❑v rNO
If so, List:
Reviewer to complete the following.•
Sq�/YES are footage of Use: _ - � ,��I. __
❑ ��` O(� Qh -4 � /
Permitted as: VII bl d1�U(/iV 16 Uf
Under Section:
Supplementary relations section:
Perkink foa`rXt�.�
��r/y{�
Required spaces:
U YES U NO
Items to be verified in the field:
Inspector: Date:
❑ YES ErNO
If so, List:
.■ YES [I NO
iii
g cu- 0
511106 Page 3 on