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DEC-17-L01a 16154 from: To:18666942505 Pa.4e:2"5 <br />QT' OF LA RORTE <br />ZONING BOARD OFA.DJVS• ;NT <br />VAMANCE PMQUEST <br />A.pplica#Ion No.: <br />01mu USE ONLY. Feet $1SQ.00 Date Received:_.�— <br />Receipt No. 1 .3 <br />ota: This Tree is Ikon-Refundablo Regardless of tb a Boards Decksion. <br />Applicant:, . • 60 VVo t) <br />Name <br />I am ilia owner of the herein deseribedproporty. I have authorized <br />to act on my behalf In tbis rnji yte'Y.y�� �{�{� f�� �',`jf <br />OSVIIer*: S r `• 1 E- A5 ,'__\E 7 6 <br />?Tame <br />,Address <br />1?ltorio <br />Y am requesting a variance to Sect, _ of the City 74ming regulations Chaptsx 106 of tue <br />Code of'Ordlnanee, Yt�--� 11 " <br />T am reryucsting this Variance for property located &t .,�f! <br />Legal Description <br />Site Plea () Minorpovelopment Site Plan <br />() Major Davelopment Slit! Plan () General Flan <br />A, Site Vlati of the propertyis Rttachetl. Also, X have Listed the InformatiDn requested below on the <br />following paces of thls form, <br />a) AU .taets zoncerning the mitter that has led up to this request. <br />b) The type of xeliefi am seeking (setbacks, Iot coverage, etc.), <br />c) Tl}s grounds upo�t which 7 aqx �aldng tbi� request, <br />* If appllcint KNOT the o1wilox, he must provide ,Ai"rife Owner's behalf. <br />in <br />listU Applicant's Signatum <br />Office Use Only <br />Site flan and Authorization (if applicable) attached? Yes() X13 ( ) <br />Date transmitted to the Board of Adjustments: <br />Meetlog Date: <br />ApplloontNotified of Date: <br />Mtice to surrounding proporty Qwnors»]Date: <br />Doard'sDoOsion: .Approved() Denied() <br />Notice of Doax& DeeisLoa mailed to Applacant/05Ylkar: <br />5:1GP56are��1'EC11P1�11ii�StdMS{as:dardFotraalZflH[rIG�0A1iDYARfA37C$,doe '�t8Y,15[�NIDfL]fe312yC <br />