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<br />CITY OF LA PORTE <br /> <br />I, <br /> <br />ZONING BOARD OF ADJUSTMENT <br />SPECIAL EXCEPTION REQUEST <br /> <br />--- - -- -- -- - - --- - -- - - - - - - - -- - - - - - - -- - - - - -- ---A~ ~ i ~ ~ ~ ~ ~~ ~ -N ~ ~ }7Fii: _. -~i. <br /> <br />OFFICi=___US~_._O)H..J: f_~~;_ _ _,_$_5_~. 00 Date Received: _~-::__-Z~ q2- <br />Rece ipt No.: -,-____p.:52z>il~ <br />NOT~: This Fee is Non-Refundable Regardless of the Board's Decision. <br /> <br />-------------------------------------------------------_.__.~_._-----._----- <br /> <br />A pp I i can t : <br /> <br />~e__ ~(!2L~~e-C4J-----------. <br /> <br />PH: ~?l-:L.;(7/ <br />P)4 4'7/-455;)", <br /> <br />Address <br /> <br />I am the owner of the herein described <br />to act on <br /> <br />property. <br />my behalf <br /> <br />~o-y-&.~-.--~1LL.ift-.----------.--- <br /> <br />I have authorized <br />in this matter. <br /> <br />Owner*: <br /> <br />Address <br /> <br />PH: tl-71-/~9/ <br />47/- ~:S-5~ <br /> <br />I am requesting a Special Exception to Sect. _ of the City <br />Zoning -Ordinance No. 1501. I ",a_m r.eqy.est;-..9 g this ~~cial Excepti~.!lJ ~or/ <br />property located at ~tO,1 ~ -4~-~. ~~44.~ 5"' ~..:l$ <br /> <br />%# L1~ I.;1SXI.26:-_Address __Le.:"l_~e~::~~~_____ <br /> <br />( ) Site Plan ( ) Minor Development Site Plan <br />( ) Major Development Site Plan ( ) General Plan <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 />_Q~ (/1- q 2- <br />Date <br /> <br />m~ provide Authorization to act <br /> <br />~~~ <br />A ica~t' s Signature--- <br /> <br />* If applicant is NOT the owner, he <br />on the Owner's behalf. <br /> <br />------------------------.----------------------------------------------- <br /> <br />OFFICE USE ONLY <br /> <br />Site Plan and Authorization (if applicable) attached? Yes (}0 No ( ) <br />Date tr'ansmi tted to the Board of Adjustments: 4J.o /-1 :2- ._.___ <br />Meeting Date: ~};.fll?:.- Applicant Notified of Date: _y.t!_.J-_______ <br /> <br />Board's Decision: <br /> <br />Approved ( ) <br /> <br />Denied ( ) <br /> <br />Notice of Board Decision mailed to Applicant/Owner: <br />