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<br />~h <br /> <br />CITY OF LA PORTE <br />ZONING BOARD OF ADJUSTMENT <br />VARIANCE 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 />VDq"'ODb <br />~-/l'O '1 <br />/otJ/',f <br /> <br />Applicant: <br /> <br />Ca~,() /0n1 <br /> <br />Name <br /> <br />I J 3Jvo II 1I~/nu.[, L <br />Ad dress <br /> <br />~j)- q1/-?2/1 <br />Phone <br /> <br />I am the owner of the herein described property. 1 have authorized <br />to act on my behalf in this matter. <br /> <br />S.e / ;= <br /> <br />Owner*: <br /> <br />~/UlL '1(c n ;1 <br />r <br />Name <br /> <br />; /370 A/.Ilv<-t!"d~Ud, L <br />Address <br /> <br />;; g) - 1/1/- g 2 I( <br />Phone <br /> <br />I am requesting a variance to Sect. <br />Code of Ordinance. <br />I am requesting this variance for property located at <br /> <br />of the City Zoning regulations Chapter 106 ofthe <br /> <br />I j 3:1 0 AI -' If J/.efl a. ~ <br />Street Address <br /> <br />L <br /> <br />Legal Description <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 ofthis 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 applicant is NOT the owner, he must provide Authorization to act on the Owner's behalf. <br /> <br />(,-1/- 01 <br />Date <br /> <br />Ct~~ y~~ <br />Applicant's ignature <br /> <br />Office Use Only <br />Site Pl:1n 2nd 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 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 />