HomeMy WebLinkAbout3040 Trousdale Drive - ApplicationCity of Burlingame Planning Department 501 Primrose Road P(650) 558-7250 F(650) 696-3790 www.burlinQame.org
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BURIJNGAME APPLICATION TO THE PLANNING COMMISSION
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Type of application: Design Review Conditional Use Permit Variance
Special Permit Other Uil1i�F Parcel Number:
Project address: 3�� �fb��,�.Q���[.
APPLICANT r;.#...�; � �,,,, - } �, }�
Name: !3r.�f A� i=c, Sur.v��.��: �T�.r
Address: 1-i y�( ,�--11 s� A��r r�`. �-
City/State/Zip: S� 1� i"�c� a-r ,��c�y�0 3
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PROPERTY OWNER
Name:_ Ci�r� 5�u �ri�rl S��'u i'�c�
Address: 15 `) 1 �1-l-��ra5 I�r�v�
City/State/Zip: l3� i 1� n nu���� �� .�i �O l O
Phone (w):
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ARCHITECT/DESIGNER
Address:
City/State/Zip:
Phone (w):
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PROJECT DESCRIPTION
Please indicate with an asterisk *
the contact person for this �rn�ect �
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S E P- 3 2003
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AFFADAVIT/SIGNATURE: I hereby certify under penalty of perjury that the information
given herein is true and o the best of my knowledge and belief.
Applicant's signatu : Date: > (f }
I know about the proposed application and hereby authorize the above applicant to submit this
application to the Planning Commission.
Property owner's signature: -��� �� �� C. '� tim� Date: �-��,� I�2, c`t��
Date submitted:
PCAPP.FRM