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,~ <br />• CITY OF LA PORTE • <br />ZONING BOARD OF ADJUSTMENT • <br />SPECIAL EXCEPTION REQUEST• ~ <br />--------------------------------------------Application No.SEO/_-•--O:f.' <br />OFFICE USE_•ONLY: Fee.=._._.,550..00 Date Received: ~_. ,~_Q(._. <br />Receipt No.. _ D!o!l~s8 <br />NOTE: This Fee is Non-Refundable Regardless of the Board's Decision. <br />Applicant: ~'~f'U~~_ W.__ (~(~£~T7~' £~.Fc~1P~_-- _-.. <br />Name ~ ~ ~ <br />Address <br />I am .t a owner of the herein described property. I have authorized <br />.S_el~ ~.-___._____.__._~___.___.. to act on my behalf in this matter. <br />_-1~~ <br />0 w n e r * : E'~e~JE ST ~ cv . G[J d^~9-TlFE~PFo~F'i~ <br />--------•----~-•-~ Name-.__---._._----------------- <br />----f~- ~. ~ S~N~ _..~}«tFdU !~~' _. P H : X76 /~ <br />Address • CR.( (~$1 l3- SD4--O~~y- <br />I am requesting a <br />Zoning Ordinance •~ <br />property located a~ <br />Special E~c,Geption <br />~~• am rest <br />Address <br />S, lob_~91(b)Ca~,) <br />to Sect. ~QS~ob ~9l(~ of the City <br />%Sting this Special Exception for <br />_ ._ s~ ~ n r ph .,~R~''~_ <br />Legal Des ription <br />( ) Site Plan ~ ~(jQ 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) A1~1 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 />~v- ~ o <br />_ w Date . <br />-~~~Ap~nt~ gn ure <br />OFFICE USE ONLY <br />Site Plan and Authorization (if applicable) attached? Yes (~ No ( ) <br />Date transmitted to the Board of Adjustments: ~ - as - o./ <br />Meeting Date: ~'~~_ ~ ~__ Applicant Notified of Date: _._._._,_.___._._._.__ <br />Board's Decision: Approved ( ) ~ Denied ( ) <br />Notice of Board Decision mailed to Applicant/Owner: _._~._.-.,•___. <br />