HomeMy WebLinkAbout2305 Valdivia Way - Application�� PLANNING APPLICATION
BURLINGAME COMMUNITY DEVELOPMIENT DEPART141ENT—PLANNING DIVISION
�501 PRIMROSE ROAD, 2ND FLOOR, BURLINGAME, CA 94010-3997
TEL: 650.558.7250 � FAX: 650.696.3790 � E-MAIL: PLANNINGDEPT(�BURLINGAME.ORG
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PROJECT ADDRESS 1
PROJE SCRIPTION �
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PROPERTY IER IAM APPLICANT?
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ARCHITECTIDESIGNER APPLICANT7
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BURLINGAME BUSINESS LICENSE �
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ADDRES�
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*FOR PROJECT REFUNDS* - Please provide an address to which to all refund checks will be mailed to:
NAME
ASSESSOR'S PARCEL # IAPN) ZONING
ADDRESS
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o- I HEREBY CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION GIVEN HEREIN IS TRUE AND CORRECT TO THE BEST OF MY
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� APPLICANT'S SIGNATURE IF IFFERENT FROM PROPERTY OWNER DATE
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� I AM AWARE OF THE PROPOSED AP LICATION AND HEREBY AUTHORIZE THE ABOVE APPLICANT TO SUBMIT THIS APPLICATION TO THE
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> PLANNING COMMISSION/ VISION.'
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LL PROPERTY OWNER'S SI NATURE DATE
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AUTHORIZATION TO REPRODUCE PLANS
I HEREBY GRANT THE CITY OF BURLINGAME THE AUTHORITY TO REPRODUCE UPON REQUEST AND/OR POST PLANS SUBMITTED WITH THIS
APPLICATION ON THE CITY'S WEBSITE AS PAR�PLANNING APPROVAL PROCESS AND WAIVE ANY CLAIMS AGAINST THE CITY ARISING
OUT OF OR RELATED TO SUCH ACTION (INITIALS OF ARCHITECTIDESIGNERI
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APPL�CATION TYPE
❑ ACCESSORY DWELLING UNIT (ADU) ❑ VARIANCE (VAR)
❑ CONDITIONAL USE PERMIT (CUP) ❑ WIRELESS
� DESIGN REVIEW (DSR) �FENCE EXCEPTION
❑ HILLSIDE AREA CONSTRUCTION PERMIT ❑ OTHER:
❑ MINOR MODIFICATION
❑ SPECIAL PERMIT (SP)
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DATE RECENED:
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