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CITY OF N PORTE <br />ZONTNTG BOARD OF ADJUSTMENT <br />Applicant: <br />W <br />Na me <br />Address <br />Em <br />I am the owner of the herein described property. I have authorized <br />to act on my behalf in this matter. <br />-I CR O)Vnei - *: <br />N2 MC <br />r;m- <br />I am requesting a variance to Sect. of the City Zoning regulations Chapter 106 of the <br />Code of Ordinance. 5—C <br />I am requesting this variance for property located at 625 o <br />Street <br />eru r <br />Legal De <br />Site Plan Minor Development Site Plan <br />0 Major Development Site Plan General Plan <br />A Site Plan of the property is attached. Also, I have listed the information requested 1)e1ow 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 />—V Q 1A <br />ateLo �Ap Iii c a n V s <br />Office Use Only <br />Site Plan and Authorization (if applicable) attached? Yes () No <br />Date transmitted to the Board of Adjustments: <br />Meeting Date: <br />Applicant Notified of Date: <br />Notice to surrounding property owners- Date: <br />Phone <br />Board's Decision: Approved () Denied ( ) <br />Notice of Boards Derision mailed to Applicant/Owner- _ <br />