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- ~ - .. CITY OF LA PORTS ''`" <br />- G BOARD OF ADJUS~NT <br />. VARIANCE REQUEST . <br />. ~ - - Application No.: OoZ _ 0 ~~ <br />OFFICE USE ONLY: Fee: $100.00 Date Received: ~ ~ D ' ` 0 ~-- <br />Receipt No.: ~, l ~-$ <br />Note: This Fee is Non-Refundable Regardless of the Board's Decision. <br />Applicant: ~,~sT .~/9~ddf L ~•snl~L' oF,B~LG~,K'~ <br />Name <br />~zTo,v~ ~'~ Address 77oPr .Phone <br />I am the owner of the herein described property. I have authorized Qi// ,~clii1 <br />to act on my behalf in this matter A ~ . <br />fj/f;iT~iiT~oGYgL 4 O/~VaI~.6/MC. . <br />Owner: ~ ~r~r~~~ . <br />,sty l ~irJ®r~vN~e ~aT •~ 7x 7~-~ cC - z,ta <br />Address . Phone <br />~~I C~ anq .~ I YO u,viTs ?'a ,20 o by DTs Pcr Pioj «T <br />I am requesting a variance to Sect. ~ ~ of the .City Zoning Ordinance No. 1501. <br />I am requesting this variance for property located at ,?2'c,1 ~w uls ~` ~tir~>~F•sk•~y <br />. ~ Street Address <br />~a G ,B,TTo ~h ~.~ ~c~ L <br />. ". Legal Description <br />(r~Site Plan - () Mino~c Developme~ Site Plan <br />()Major Development Site Plan ()General Plan - - <br />A Site Plan of the property is attached. Also, I have listed the information requested below <br />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 ct on the Owner's <br />behalf. <br />/o-z3-O2 <br />Date ~ Applicant'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: <br />Applicant Notified of Date: <br />Notice to surrounding property owners -Date: <br />Board's Decision: Approved () -Denied ( ) <br />Notice of Board Decision mailed to Applicant/Owner: <br />