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<br />OFFICE USE ONLY: <br /> <br />Application NO.:V' 0 %'.- {)O I <br />Date Received: . / - 211-t} Y <br />Receipt No.: 5 f)g--/} J <br />This Fee is Non-Refundable Regardless of the Board's Decision <br /> <br />CITY OF LA PORTE <br />ZONING BOARD OF ADJUSTMENT <br />VARIANCE REQUEST <br /> <br />Fee: $150.00 <br /> <br />Note: <br /> <br />I am the owner of the herein described property. I have authorized <br />to act on my behalf in this matter. . <br /> <br />Owner*: ~ at ef;~wm. kc-' <br />{ <br />Name <br />3 (1 O? A-l4Crnn WVL d ' <br />Address <br /> <br />~ A-V~O A--t'F vJr+I-- (~4() <br /> <br />Name <br /> <br />qoC; cf!-~&TII"'1 f?ff- HvUj~/'-\~ (-1I~) b~)r-~ 470 ~ <br />I 7 7d~J.. Phone- <br />M ~ &3 Z).2~ r q:s4} <br /> <br />Address <br /> <br />Applicant: <br /> <br />Phone <br /> <br />I am requesting a variance to Sect. of the City Zoning regulations Chapter 106 of the <br />Code of Ordinance. IL ~ . <br />I am rcqu~$ting this variance for property located at ~ '$ 209 ~ ( I/5'f 1:r~~ <br />~.. Street Address <br />rr- lb. ~ '),-. n to ~~(l. r 0"~ c-L "vI');;' 6Y'-/ <br />I ' Legal Des ription <br /> <br />~ite Pia n <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 of relief I am seeking (setbacks, lot coverage, etc.). <br />c) The grounds upon which I am making this request. <br />* If alJplkant is NOT the owner, he must provide Authorization to act on the Owner's behalf. <br /> <br />K2w~~e <br /> <br />l-- ~(-D8 <br />Date <br /> <br />Office Use Only <br />Site Phn 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 {)wners- Date: <br /> <br />Board's Decision: <br /> <br />Approved ( ) <br /> <br />Denied ( ) <br /> <br />Notice of Boards Decision mailed to Applicant/Owner: <br />