HomeMy WebLinkAbout817 Edgehill Drive - Application�rb c�r o�
� BURUN�AMi CITY OF BURLINGAME
���� APPLICATION TO 1�-iE PLANNING COMIVIISSION
��. .,�
Type of Application: Special Permit Variance,�Other 0� Gnl' dyt, �-LrM c�i ��
Project Address: �� 7����.6' C LC� �LLr/'�
Assessor's Parcel Number(s): � 2-�'! -- O�—��v
APPLICANT �
Name: �� G
Address: 6 6z� � C�-� c n10 ✓Lk�-r�
City/State/Zip: S� %�rt-t/�Jc� /C'.B—�9�Ca�
Phone (w): �6 �) .��7 � �l6 �_�
(h):
f�� �.�'o ) �73 -.3 Ls3
,
r�R�`l TECT ESIGNER
Name: ���� � �d-"S J'
Address:
City/State/Zip:
Phone (w):_
(h):
fax:
PROPERTY OWNER ��{����i��,��-��c''
Name:l� r
Address: �i � �j%� �// ��
City/State/Zip: �i���'v ��/��r- C� �1G1�
Phone (w�: ��� — ����
�h�: S`S� - �Z y �
fax: 3�-t7_73��'
Please indicate with an asterisk * the
contact person for this application.
PROJECT DESCRIPTION: tii c�✓�- tirv/J��C',�n.�% p�,c�� j�`r� ,��
lT7 �/ �G� �L N�o �( 1/Lu.[%�-.� A� 7� y� Lt/ L�� i (/I% 4�1�/liJh J G�`I ^7� � G i
i ✓'l�q� ✓ I
N��
�
the information given
AFFIDAVIT/SIGNATURE: I hereby certify under penalty of perjury that
herein is true and correct to th b st of my icnowledge and belief.
l � �S
Applican s Sig ature Date
I know about the proposed application and hereby authorize the above applicant to submit this
application to the Planning Commission.
Date Filed:
X �n�� ������` �� ���%�9
Property Owner's Signature Date
----------------------FOR OFFICE USE ONLY ------------------�-�-1.�-��-� �-�
Fee:
DEC � 4 1999
Planning Commission: Study Date: Action Date: r. � r v 0 F B U R L f N G A f� F:
PLANNING DEPT