Laserfiche WebLink
i• <br />_ ~ECEIVEp <br />CITY OF LA POP,TE • <br />JA~V 7 5" ~°~5f~ ZONING BOAP,D OF ADJUSTf•4ENT <br />" ' L Cf,+FO~R~Er~r, SPECIAL EXCEPTION REQUEST <br />• s-~,/ App~ication fJo.: ~ >- _ <br />OFFICE USE OfJLY: Fee: ~•1'@~:-4D_ Date Received: /"~~ -4~S'~ <br />Receipt No.. ' ~: /'9'~3C~ <br />NOTE: This Fee is Eton-Refundable Regardless of the Board's Decision. <br />Applicant: <br />P.ddress <br />PH: <br />Gt/~ai <br />~o--the owne of the herein described property. have <br />,sue. y~,a„o - r~-~-~a-a to act on my behalf in this <br />~~~ ~ Pn' <br />authorized <br />matter. <br />Ow n e r ~ : ~ -t-~` ~ <br />Name <br />Address <br />I am reo,uesting a Special Exception to Sect: ~ ~ ~ of the City <br />Zoning Ordinance No. 1501. I am reques~g this Special Exception <br />property located at La! D ~ `~ , h •~- <br />Address Legal Description <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 <br />information requested below on the following pages of this form. <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 malting this request. <br />~ If applicant is NOT the owner, he must rovide Authorization to act <br />on the Owner's behalf. <br />Date Applicant's S•gnature <br /> <br />OFFICE USE ONLY <br />Site Plan and Authorization (if applicable) attached? Yes ('') No ( ) <br />Date transmitted to the Board of Adjustments: <br />Meeting Date: <br />. <br />,/ <br />f _ / -- =' Y <br />Applicant Notified of Date: ~-l~/~~~~ <br />• Board's Decision: Approved ( ) Denied ( ) <br />Notice of Board Decision mailed to Applicant/Owner: <br />