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CITE' OF LA FORTE <br />ZONING BOARD OF ADJUSTAIENT <br />VARIANCE REQUEST <br />Application No.: <br />OFFICE USE ONLY: Fee: S150.0Q Date Received: -tea-13 <br />Receipt No.: <br />Note: This Fee is Non -Refundable Regardless of the Board's Decision <br />Applicant: <br />Name <br />Address Phone <br />lam the owner of the herein described property. I have authorized <br />to act on my behalf in this matter. <br />Owner*: <br />Name <br />Address Phone <br />I am requesting a variance to Sect. of the City Zoning regulations Chapter lab of the <br />Code of Ordinance. <br />I afn requesting this variance for property located at v7v % Z- <br />Street Address <br />Legal Description <br />Site Plan { } Minor Development Site Plan <br />{ } Maj or 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 n-iust provide Authorizat to act on the Owner's behalf. <br />Date <br />Offic ' se 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 />licant's Signature <br />Board's Decision: Approved () Denied () <br />Notice of Boards Decision mailed to Applicant/Owner: - <br />