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<br />CITY OF LA PORTE <br />ZONING BOARD OF ADJUSTMENT <br />VARIANCE REQUEST <br />Application No.: V 0' l -0 0 I J <br />OFFICE USE ONLY: Fee: $150.00 Date Received: 'b ,~q- ~ i <br />Receipt No.: '0 LflfO <br />Note: This Fee is Non-Refundable Regardless of the Board's Decision <br /> <br />Applicant: <br /> <br />jJ\ Cd k~" V" lilt "Uv--h~ l.t-<> V- <br /> <br />I Name <br /> <br />\ cJCj Z VI <br /> <br />A)J ~q~l I \^- <br />Address <br /> <br />L t~J=1~ ~ 1~ <br />lIS.~7 I <br /> <br />lSl ( yl 0 7_".1 () --7 <br /> <br />Phone <br /> <br />I am the owner of the herein described property. I have authorized <br />to act on my behalf in this matter. <br /> <br />Owner": ~~ork ~ -'Iv [)j-l/).l"' ..r;~ ") QV <br />Name <br />I 0("(2 l~ ~R ~ Ql\ I ~. <br />Address <br /> <br />t j\ \~(~1~ <br />-r-l~) 7/ <br /> <br />'28 i- \./70 2\lO ) <br /> <br />Phone <br /> <br />Lal" <br /> <br />BLocfc <br /> <br />of the City Zoning regulations Chapter 106 of the <br />I Del Z L: f\/u ~ (" \J ,k <br />I ..street Add~ss <br />.\,...- 0. \ y fnOr-J -r PI C f.As:r S Q CTI (j.-J <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 />q <br /> <br />Legal Description <br /> <br />id- <br /> <br />~ <br /> <br />("ySite 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 of this form. <br />a) All facts concerning the matter that has led up to this request. <br />b) The type ofreliefl am seeking (setbacks, lot coverage, etc.). <br />c) The grounds upon which I am making this request. <br />· If appHcant ;, NOT the own.., he mn,t prov;de Anthonzation ~n the Owner', behalf <br /> <br />-l J t J L ~ /14? .-j ---1M.a~.k-i1>:- <br />Date Applicant's Signature <br />Office Use Only <br />Site Plan and 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 />