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. A: <br />• CITY OF LA PORTE <br />ZONING BOARD OF ADJUSTMENT <br />SPECIAL EXCEPTION REQUEST- <br />--------------------------------------------- Application No.. - OQ <br />OFFICE _USEONLY: Fee.;._._.:$50.00 Date Received: �' <br />Receipt No.: _ I _D8? <br />NOTE: This Fee is Non -Refundable Regardless of the Board's Decision. <br />------------------------- <br />------------- <br />Applicant: <br />JJL <br />Address <br />I am the owner of the herein described property. I have authorized <br />to act on my behalf in this matter. <br />���LT! <br />Owner: �_G��ib-5-e_-__--_--•—_-- <br />Avg-ro..------•-•,l-• 77-471 PH: <br />Address I <br />I am requesting a Special Exception to Sect. of the City <br />Zoning Ordinance.".- I am r questing this Spe ial xce tion for <br />property located at l i ic1E'_.__ ,,- <br />Address Legal Descript on <br />(V,� 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 Oust provide Authorization to act <br />on the Owner's behalf. <br />YJA _766,4w <br />ate Ap6licant's Signature <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 ( ) Denied ( ) <br />Notice of Board Decision mailed to Applicant/Owner: <br />