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<br />CITY OF LA PORTE <br />ZONING BOARD OF ADJUSTMENT <br />V ARJANCE REQUEST <br />Application No.: <br />OFFICE USE ONLY: Fee: $150.00 Date Received: <br />Receipt No.: <br />Note: This Fee is Non-Refundable Regardless of the Board's Decision <br /> <br />Vo1---0VS <br />g ..J 1-(") 7 <br />1,??Sttcf <br /> <br />Applicant: <br /> <br />(J)1/;~;41 /';K~/21 ~I <br /> <br />Name <br /> <br />3 //}:J- c~v.eect;; <br /> <br />Ad dress <br /> <br />?? 3~--';:2? 5" - ? 7 CPr <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 />E;e J,p-J <br /> <br />hi / (;Yffn, #€~I d <br /> <br />Owner*: <br /> <br />M/?/2/ ci <br /> <br />Name <br /> <br />Address <br /> <br />~ 3A'- 35i- :5/ /3 <br />Phone <br /> <br />I am requesting a variance to Sect. of the City Zoning regulations Chapter 106 of the <br />Code of Ordinance. <br />I am requesting this variance for property located at <br /> <br />Street Address <br /> <br />,,- <br />L 0)-;;;'0 .(;Z8d:-,3 <br />() Site Plan <br />() Major Development Site Plan <br /> <br />Legal Description <br />5~/:l.. <br /> <br />p~)-- f/ #/CK EI4-51 <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 ofreliefI 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 /> <br />th7~9 ~ ~ <br /> <br />I Da"te . . Applicant's Signature <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 owners- Date: <br /> <br />Board's Decision: <br /> <br />Approved ( ) <br /> <br />Denied ( ) <br /> <br />Notice of Boards Decision mailed to Applicant/Owner: <br />