Laserfiche WebLink
CITY OF LA PORTE <br />ZONING BOARD OF ADNSTMENO <br />SPECIAL EXCEPTION REQUEST <br />Application No.: p y — Oo l <br />OFFICE USE ONLY: Fee: $150.00 Date Received: <br />Receipt No.: 3 6517 <br />Note: This Fee is Non -Refundable Regardless of the Board's Decision <br />Applicant: Lz; , Al (e „1 fyl G'�, < <br />Name <br />Address <br />I am 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 <br />PH: <br />I am requesting a Special Exception to Sect. /M I Ji of the City Zoning regulations Chapter 106 <br />of the Code of Ordinance. <br />I am requesting this Special Exception for property located at 9 VJ Oc& &. d✓ c <br />J/ Street Address <br />? A n fie, J l6 f i� iZ �� /� k G-r�4�� 1��,.sr,6• ��.� <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 malting this request. <br />* If applicant is NOT the owner, he must provide Authorization to act on the Owner's behalf. <br />Date Applicant's Signature <br />Office Use Only <br />Site Plan and Authorization (if applicable) attached? Yes ( No ( ) <br />Date transmitted to the Board of Adjustments: i — (D — 6 JI <br />Meeting Date: �� ' 0 L` Applicant Notified of Date: y <br />Board's Decision: Approved () Denied ( ) <br />Notice of Boards Decision mailed to Applicant/Owner: <br />