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<br />CITY OF LA PORTE <br />ZONING BOARD OF ADJUSTMENT <br />SPECIAL EXCEPTION REQUEST <br />Application No.: ~r cb - DO :3 <br />OFFICE USE ONLY: Fee: $150.00 Date Received: a ~o.l d(t)~ <br />Receipt No.: <br />Note: This Fee is Non-Refundable Regardless of the Board's Decision <br /> <br />Applicant: <br /> <br />]lm E SehOol~L1 <br /> <br />Name <br /> <br />ct ~O l rn Oht~O h'\~r~ <br /> <br />ddress <br /> <br />PH: .2 CO \ . 4,li. '22lO'1 <br /> <br />I am the owner of the herein described property. I have authorized <br />to act on my behalf in this matter. <br /> <br />Owner*: <br /> <br />Name <br /> <br />PH: <br /> <br />Address <br /> <br />I am requesting a Special Exception to Sect. / q I of the City Zomng regulations Chapter 106 <br />of the Code of Ordinance. t? '1/11. _ / I . <br />I am requesting this Special Exceptiou for property located at 71.0 I r I W} 7 9 ()/Yl (/ill-/} <br />II J ---i/ I ..L / _ I StreE;,t Address <br />',*,c7 :n-/O'l9L/ hi 1~7 ~t::Jj Ii IJ + Lt 1'1~ nLI( 1/ <br />Legal Description 5pi:/h-J ll.l< PI r.re.c: .f'~c. 2. <br /> <br />( ) Site Plan <br />( ) Major Development Site Plan <br /> <br />( ) Minor Development Site Plan <br />( ) General Plan <br /> <br />A Site Plan of the property is attached. Also, I have listed the information requested below on the <br />following pages of this form. <br />a) All facts concerning the matter that has led np to this request. <br />b) The type ofreliefI 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 <br /> <br />Office Use Only <br /> <br /> <br />2-3-/)tp <br /> <br />Date <br /> <br />Site Plan and Authorization (if applicable) attached? Yes () No () <br /> <br />Date transmitted to the Board of Adjustments: <br /> <br />Meeting Date: <br /> <br />Applicant Notified of Date: <br /> <br />Board's Decision: <br /> <br />Approved ( ) <br /> <br />Denied ( ) <br /> <br />Notice of Boards Decision mailed to Applicant/Owner: <br />