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CITY OF LA FORTE <br />~G BOARD OF ADJU~NT <br />VARIANCE REQUEST ~ V , <br />.,~. <br />Application No.: ~ 03 -~ 00 2 <br />OFFICE USE ONLY: Fee: $100.00 ~ Date Received: ~ 0 ~a - / 7 0 ~ <br />Receipt No.: ~ nl'/.n <br />Note: This Fee is Non-Refundable Regardless of the Board's Decision. <br />Applicant: ~.~ , 1~~/1:~ ~os'e~ L <<;:'~ ~'yiQSrs <br />Name <br />.Address Phone <br />I am the owner of the herein described property. I have authorized <br />to act on my behalf in this matter. ~ ~ . <br />Owner*: <br />Name <br />Address . Phone <br />. b <br />I am requesting a variance to Sect. UI b -/,~~I ~f the City Zoning Ordinance No. 1501. <br />I am requesting this variance for property located at ~ `/l Dom: ~ ~~ ~ ~ ~ ~ <br />Street Address <br />rack ~ U ~~t' - ~Z~G~°f i~ -~- :; ~I~~ ~~ ~~ , h~rc O~~rk <br />. Legal Description <br />()Site Plaa ~ ~ () Minox Development 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 fads 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 on the Owner's ~ . <br />. behalf. ~~~~ <br />/,%~~' <br />Date App cant'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 />