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<br />CITY OF LA PORTE <br />ZONING BOARD OF ADJUSTMENT <br />VARlANCE REQUEST <br /> <br />Application No.: <br />OFFICE USE ONLY: Fee: $150.00 _ Date Received: <br />Receipt No.: <br />Note: This Fee is Non-Refundable Regardless of the Board's Decision <br /> <br />V~r - 00 'i <br />&/3 D <br />IJ :2 a 0/ ;:l. <br /> <br />Applicant: <br /> <br />tI e Y 5 it e.l "B. "B u..e-k m'l l 'e. r <br />Name <br /> <br />.-IfISo. JJ u-~e AI 1" L aPo'r te.) Te'l.o..s <br />Address <br /> <br />2.ctl- 410-.l1? 13 <br />Phone <br /> <br />I am the owner ofthe herein described property. I have authorized <br />to act on my behalf in this matter. <br /> <br />Owner*: <br /> <br />He.rsheJ B. Bu_ej((\!\.; i \e... <br />Name <br /> <br />:2./7 So. JJ u-~S~.j la Po,... t'e.- Tq..d-s 11571 c2.'? i- t{ 70- 2<g7 3 <br />Address Phone <br /> <br />I am requesting a variance to Sect. I (J fo.- /'1 I of the_City Zoning regulations Chapter 106 of the <br />Code of Ordinance. . <br />I am l-cquesting this variance for property located at 2..1 7 ~ 0 ~Al u...~ e (l T <br />Str Address <br />'i; l}Jjle.. Fa.~\\'I .Vwe.1 \ ~(\'1. <br />. Legal Description <br /> <br />() Site Plan <br />() Major Devrlopmcnt 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 ofreliefI am seeking (setbacks, lot coverage, etc.). <br />c) The grounds upon which I am making this request. <br />* If al:plh:ant is NOT the owner, he must provide Authorization to act on the Owner's behalf. <br /> <br />fo-"3D- D'2 <br />Date <br /> <br />:Jr: fi: g.a~-<-Pd4 <br />Applicant's Signature <br /> <br />Office Use Only <br />Site PI:m 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 />Notice to sUI-rounding 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 />