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<br />...}-. <br /> <br />C'A <br /> <br />C::TY C-? LA PORTE ~ <br /> <br />ZONING BOARD OF ADJUSTMENT <br />SPECIAL EXCEPTION REQUEST <br /> <br />--------------------------~~;~~----------A~~l~~~~~~~-~~~~-~?=-CO~- <br /> <br />OFFICE USE ONLY: Fee: $100.Q8- Date Received: ~--/O--,.frY <br />Receipt No.:. C;- "'> ..}, '-I-:J... <br />NOTE: This Fee is Non-Refundable Regardless of the Board's Decision. <br /> <br />--------------v-o-r-~q)~~--~9(~-~~--~~------------------------ <br />Applicant: vY'\, e....t. c\ f' \ A. \""". 0 ~- r \ C\ v~_ L <br />\ Nam~ \ n ~ \ 11- '- - (, <br />i 7o:L Sou -t- "" 1,:) LV C\ ,I LA\' c) ('\ e... PH: 'I 11- / :.' Lfl <br />Address I <br /> <br />}, <br />.~ <br />, ~ <br /> <br />I am the owner of the herein described property. I have authorized <br />to -act on my behalf in this matter. <br /> <br />'M \ ~~\" C\. x- \ f\.~. ~ ,~c \ ~~0 e."'L 0' ~ <br />l7cJd.- Sou{~e \j\vc\,,-{ L.A ~f)(-\'4H: W-7f-j;-11) <br />Address ,_ <br />--- <br />I am requesting a Special Exception to Sect. !/(po.r::ZIJ of the City <br />Zoning Ordinance No. 1501. I am requesting his ~peciAI E ception for <br />property located at I' 0" C B\ W",,- Lo.... t'of' of> <br />c \ \ \ Address , Legal Descri. ption <br />(' -,- C\.... ~ ~ J::: 0... '\- \ 0 ^ ~ 0 "''\ \) \ ~. ^ c.... ~ _ S" -\-. a 'f ~. <br />I <br />(v) Site Plan (~Minor Development Site Plan <br />( ) Major Development Site Plan ( ) General Plan <br /> <br />Owner*: <br /> <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 making this request. <br /> <br />* If applicant is NOT the owner, he must provide Authorization to act <br />on the Owner's behalf. <br /> <br />3//om <br />I Dite <br /> <br />-(ffi01/lr1dc,~ <br />Appli~ant' Signature <br /> <br />----------------------------------------------------------------------- <br /> <br />OFFICE USE ONLY <br />Site Plan and Authorization (if applicable) attached? Yes (~/ No ( ) <br /> <br />Date transmitted to the Board of Adju~tments: <br /> <br />4~J'/~3 <br />I I <br /> <br />Meeting Date: <br /> <br />Applicant Notified of Date: <br /> <br />Board's Decision: <br /> <br />Approved ( <br /> <br />Denied ( ) <br /> <br />Notice of Board Decision mailed to Applicant/Owner: <br />