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�r <br />CITY OF LA PORTE <br />ZONING BOARD OF ADJUST T j! s JUL .1 8.2001 � I <br />SPECIAL EXCEPTION REQUEST- <br />---------------------------------------- ---------- - <br />A�p p 1 i c a t: o•"n..'.'.N.--�.•-.-- �:�- - � <br />OFFICE USE ONLY: Fee_$50.00 Date Received: <br />Receipt No.. <br />NOTE: 'This Fee is Non -Refundable Regardless of the Board's Decision. <br />Applicant.I,IJlI <br />-- Nme . <br />Address - <br />I am the owner of the herein described property. I have authorized <br />_____:_ __ ________.__1______,__•. to act on.my behalf in this matter. <br />Owner*:_-- <br />ame <br />PH <br />Address <br />I am requesting a Special Exception to Sect. _1_g_J±acA_of the City... <br />Zoning.Ordinance No. 1501. I am requesting this Special Exception for <br />property located at 1_. Lc--� 4__.-,—__._.�_. <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 Authorizati to act" <br />on the Owner's behalf. ^ <br />Date Applicant/Is Signatur <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 />