HomeMy WebLinkAbout2404 Valdivia Way - ApplicationCity of Burlingame Planning Department 501 Primrose Road P(650) 558-7250 F(650) 696-3790 www.burlin a� me.org
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APPLICATION TO THE PLANNING COMMISSION
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Type of application: Design Review Conditional Use Permit Variance
Special Permit Other Parcel Number:
Project
APPLICANT
PROPERTY OWNER
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Name: 1�1�I�IL �%���c�%�L
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ARCffiTECT/DESIGNER
Name: ��'���L � :�� - � �
Address: � �: �
City/State/Zip: �'� i ��' `'. �'i ' f%t'� Please indicate with an asterisk *
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PROJECT DESCRIPTION: �,
the contact person for this project.
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AFFADAVIT/SIGNATURE: I hereby certify under penalty of perjury that the information
given herein is true and correct to the best of my kn wledge and belief.
Applicant's signature: '' -�7�� Date: G'�
I know about the proposed application and hereby authorize the above applicant to submit this
application to the Planning Comny�sion. ,
Property owner's signature:
Date:
bmitted: R E� I V� D
JUL 2 2 2003
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