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HomeMy WebLinkAbout1011 Toyon Drive - Application� i41` CIT w � BURLJNQ.e.Mi CITY OF BURLINGAME �� �= , APPLICATION TO THE PLA,NNING COMIVIISSION ��..,,� Type of Application: Special Permit Variance�Other Project Assessor's Parcel Number(s): L���, �-�� _� �.? •�,��''�a APPLICANT Name: ,������,�' �s �r�; °�- PROPERTY OWNER Name: ����� ��.- y ��� ;� Address:_��1���,,,,� �9�� Address: ,��1�.r� ;y�ea � /ar. City/State/Zip:_r_����',�v�,�,�1� �� ��1��,�� City/State/Zip: a���'-����,� �+,¢ 9���/'t� Phone (w):�(��',�"S /f3S'�S� Phone (w): ��,� � �.� ",��`� 'S- (]l�; //� 5 �' � . � �'� �cy3 � fax: ���;�a ����-���� � ARCHITECT/DESIGNER PROJECT DESCRIPTION: AO•� _ •�� . � �� � Name: �7 �v�sA�c �r�r��/>,�,� Address: `�� �: i,�� f �p� �,� City/State/Zip: ,('���a� /a�]r�,�,�.� . i'A �y�'.�4'. Phone (w):�15' Q � =� - il� d (h): fax: (h): /�i�-,1 �` �v'-�G �; � � �' 3 f1X. //.,' -� ✓ � s'��{ � 1.�'i �' Please indicate with an asterisk * the contact person for this application. � AFFIDAVIT/SIGNATURE: I hereby certify under penalty of perjury that the information given herein is true and conect to the best of my knowledge and belief. .--,-� ;�� r�a�-'`���-�: f/'- � -- 5`'� Applicant's Signature Date I know about the proposed application and hereby authorize the above applicant to submit this application to the Planning Commission. �--��.����...:z �C`�i��c�c��� � .�% ? �',,� Property Owner's Signature Date � ----------------------------------------------FOR OFFICE USE ONLY -----------------------------------------• Date Filed: ! � �l � F�: 2/ C� - � p�` � 0� 3 v Q v(�{/�, � Planning Commission: Study Date: Action Date: