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• CITY OF LA PORTE • <br />ZONING AOARD OF ADJUSTMENT ' <br />SPECIAL EXCEPTION REQUEST <br />-----s ~-------------------------------- ------------------- ------ <br />E~~,,~sb~' Application No.. 99 OOoZ <br />OFFICE USE .ONLY : Fee,;._._._:550.00 ~ Qom, Date Received : 3 _o?~f _ q,q <br />Receipt Ne.: ~+~. I~- <br />NOTE: This Fee is Non-Refundable Regardless of the Board's Decision. <br />Applicant: ~~~~~N~Z~__._._._,_____r.r._____ ,. <br />Name <br />~_D~R~o~c,_ jq, ~ LA 1 on~T ~n s '7 7 57 _ PH : 281.4'LI- 28G? <br />Address <br />I am the owner of the herein described property. I have authorized <br />_~,,,,~,~,~J~,~~y~~,~,~.Q1E~"" ___._._._. to act on my behalf in this matter. <br />Owner*: ~QlL9.N.~elOl~J.~~~ 4Z~.____-~,~ _. <br />Name <br />__P n~.~s~c~.~.-~ ~.~~F.~ceS_:?_7.,572 _. PH. Z~i"4l1_ 2~ <br />Addre s <br />I am requesting a Special Exception to Sect. /O~a"~ 91 ~ ~~~~~ of the City <br />Zoning Ordinance No. 1501. I am requesting this Special Exception for <br />property located at 111,~,2..~.~ 5~ ___~r_3_~vcr 38 Lo_~~~Tosy~•y~ L.~+ Pea.Z~ <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 making this request. <br />* If applicant is NOT the owner; he must provide Authorization to act <br />on the Owner's behalf. <br />Date pplicant's Signature <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: ~~.~~ ,~ Applicant Notified of Date: _._.___.__._._._._.__ <br />Board's Decision: Approved ( ) Denfed ( ) <br />Notice of Board Decision mailed to Applicant/Owner: _.___..___.___.__ <br />