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<br />OFFICE USE ONLY: <br /> <br />CITY OF LA PORTE <br />ZONING BOARD OF ADJUSTMENT <br />VARlANCE REQUEST <br />Application No.: \J 0 '1. 00"')'" <br />Dale Received: ~~O - ~'~ <br />Receipt No.: ru <br />This Fee is Non-Refundable Regardless of the Board's Decision <br /> <br />Fee: $150.00 <br /> <br />Note: <br /> <br />Applicant: <br /> <br />J~?t{\)~ -{ \l \ r ~H)R \ R f\\ ~ \\\\D L~ ~ <br />Name <br /> <br />.fu 1..\ P .P\S\ C' S -, . <br />Address <br /> <br />d8\-LP610-&<6 \ 3 <br />OR <br />6)CX1- LDQn - C;)8\D <br />Phone <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 />Address <br /> <br />Phone <br /> <br />I am requesting a variance to Sect. of the City Zoning regulations Chapter 106 of the <br />Code of Ordinance. <br />,_ I am requesting this variance for property located at ~ f' ,P.Sl (' _ S.,. <br /> <br />,lrf;; 021" -.oIj , tM 43 !!,clctj f,v: vi b, ! (' 1 /,>, /; Street Address <br /> <br />'- Legal Description <br /> <br />() Site Plan <br />( ) Major Devdopmcnt 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 up to this request. <br />b) The type of relief! am seeking (setbacks, lot coverage, etc.). <br />c) The grounds upon which I am making this request. <br />* If al:plkant is NOT the owner, he must provide Auth ization to act on the Owner's behalf. <br /> <br />~ <br />Date <br /> <br /> <br />e <br /> <br />Office Use Only <br />Site Phn 2nd Authorization (if applicable) attached? Yes () No () <br /> <br />Date transmitted to the Board of Adjustments: <br /> <br />Meetir:g Date: <br /> <br />Applicant Notified of Date: <br /> <br />Notice to surrounding property owners- Date: <br /> <br />Board's Decision: <br /> <br />Approved ( ) <br /> <br />Denied ( ) <br /> <br />Notice of Boards Decision mailed to Applicant/Owner: <br />