HomeMy WebLinkAbout115 Clarendon Road - ApplicationBURLINGAME
COMMUNITY DEVELOPMENT DEPARTMENT • 501 PRIMROSE ROAD • BURLINGAME, CA 94010
p: 650.558.7250 • f: 650.696.3790 • www.burlingame.org
APPLICATIOiV TO THE PL�4fVNING COMIVIISSION
Type of application:
❑ Design Review ❑ Variance ❑ Parcel #: C��� 2 % � � ��
❑ Conditional Use Permit ❑ Special Permit �L�' Other: 1v�� ��;-r�j�,�, �e,�\;;tc; u�i-�.
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PROJECT ADDRESS:
APPLICANT project contact person �' PROPERTY OWN�R project contact person ❑
����O Payor of DSR deposiUhandling fee ❑ Payor of DSR deposiUhandling fee ❑
� K to send electronic copies of documents ❑ OK to send electronic copies of documenfs ❑
Name: �I.���t� ��j�.� �� Name:
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Address: �1� ��,�11���`i��� �
City/State/Zip: ��,�'?.�-�-�C�l�G1��
Phone: �f%5�,�!��� � �� ��
Fax: �`��� � �Y�� 02 � �/�
E-mail: ��-�.� �� u� ��-� 5 � �G��C; lG��z
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ARCHITECT/DESIGNER ro�ect contact Person ❑
Payor of DSR deposit/handling fee ❑
OK to send electronic copies of documents ❑
Ad d ress:
City/State/Zip:
Phone: ( �`�� � `7 �J �� 1 � �J
Fax: \`-�t �1 / � � L>�2�� 7 %
E-mail:
Name: ���!��- � � 1R��� ��
Address:
City/State/Zip: �
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Phone: �� �a� �� � G Z�"( �
Fax:
E-mail: �Ll'����-a ���� ��•� C12� j�f� �2,� R Cci'li(/�
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* Burlingame Business License #: �� � � �
PROJECT DESCRIPTION:
AFFADAVIT/SIGNATU RE:
best of my knowledge and f
ApplicanYs signature:_
I am aware of the proposed
Commission.
Property owner's signatu
C,�.�
� �. d I �
1: � �_� �= � .f � ;
_ � =
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certify und
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of perjury that the information given herein is true and correct to the
Date: G( / / �f' /j `�
ze the above applicant to submit this applic�ion to the Planning
Date: /� � �^�T
Date submitted:
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�c Verification that the project architect/designer has a valid Burlingame business license will be required by the
Finance Department at the time application fees are paid. s:�HaN�ours�Pcapprr�atto�.do�
This Space for CDD
Staff Use Only
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Project Description:
KeV: .
CUP
DHE
DSR
E
N
SFD
SP
Conditional Use Permit
Declining Height Envelo
Design Review
Existing
New
Single Family Dwelling
Special Permit