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CITY OF LA PORTE <br /> ZONING BOARD OF ADJUSTMENT <br /> VARIANCE REQUEST <br /> Application No.: /1— 93 ©0000/ <br /> Or'F10E USE ONLY: Fee: $150.00 Date Received: . 3 -1-/-// <br /> Receipt No.: 6 931/ <br /> Note: This Fee is Non - Refundable Regardless of the Board's Decision <br /> Applicant: 1S %C,1OIki b 5QAITS <br /> Name <br /> 9c:26 SEA aREEZ LA PagTT 743- E5V-' /?7 <br /> Address Phone <br /> I am the owner of the herein described property. I have authorized <br /> to act on my behalf in this matter. <br /> Owner *: 1 1 C-R A< S PAg �5 <br /> Name <br /> ciao sEA $Wei 7/ 3 -SSA 7 <br /> Address Phone <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 <br /> Street 'C. <br /> 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 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 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 Authorization to act on the Owner's behalf. <br /> / <br /> Date Applicant's Signature <br /> Office Use Only <br /> Site Plan and Authorization (if applicable) attached? Yes 0 ) No ( ) <br /> Date transmitted to the Board of Adjustments: <br /> Meeting Date: Applicant Notified of Date: <br /> Notice to surrounding property owners- Date: • <br /> Board's Decision: Approved () Denied ( ) <br /> Notice of Boards Decision mailed to Applicant/Owner: <br />