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CITY OF EGA P ORTE <br />ZONING BOARD OF AIDJITS' MENT <br />VARIANCE REQUEST <br />Application No.: <br />OFFICE USE ONLY: Fee. $I50.00 Date Received: <br />Receipt No.: <br />Note: This Fee is Non -Refundable Regardless of the Board's Decision <br />Applicant: ��`I Ca:tiraref 3-•L S ��c�4 A`Ps - 4Vo, f , .Jf �� c <br />Name <br />Address Phone <br />I am the owner of the herein described property. 1 have authorized <br />to act on nny behalf in this matter, <br />Owner*: <br />Name <br />Address <br />Phone <br />I am requesting a variance to Sect. Jt6 — ?35'-of the City Zoning regulations Chapter 106 of the <br />Code of Ordinance. <br />I aria requesting this variance for property located at _ r C�:'�`D� ef- vc(' ; <br />Str et Address <br />if Legal Description <br />Gv 0JP I - : �� 4 e- Y),,- IJ I, <br />Site Plan () Minor Development Site Plan <br />{) Major Development Site Plan () General Plan <br />A Site -Plan of the property is attached. Also, I have listed the information requested below on the <br />following pages of this farm. <br />a) All facts concerning the matter that has led up to this request. <br />b) The type of relief I am seeking (setbacks, lot coverage, etc.). <br />c) The grounds upon which I am making this request. <br />If applicant is NOT the owner, he must provide Authorization to act on the Owner's behalf. <br />21 /2-, /a/v fc <br />Date Applicant's Signature <br />Office Use Only <br />Site Plan Fnd Authorization (if applicable) attached? Yes () No { ) <br />Date transmitted to the Board of Adjustments: <br />Meeting D ate: <br />Applicant Notified of Date: <br />Notice to surrounding property owners- Date: <br />Board's Decision: Approved () Denied () <br />Notice of Boards Decision mailed to Applicant/Owner: - <br />