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HomeMy WebLinkAbout2517 Valdivia Way - ApplicationCity of Burlingame Planning Department 501 Primrose Road P(650) 558-7250 F(650) 696-3790 www.burlingame.org �r�, ciTr o.n BURIJNGAME APPLICATION TO THE PLANNING COMMISSION ;�� p Type of application: Design Review Conditional Use Permit Variance �%,q. C� Special Permit Other Parcel Number: Project address: Z�� 7(/��—��/ ���9- wf} APPLICANT Name: le� �-ER i� �i1 ��7� Address: ZS � � !/q�c.� iv rA wR 7 City/State/Zip: �Uie��^� �?y'^�F C.� �i�iu io Phone (w): G� �� i � S� (h): �i Sb G 9� 6�-y4 �fl: Gs� 6 y � 6��b ARCHITECT/DESIGNER Name: .SG� as A�/�/� c..�i PROPERTY OWNER Name: ,('G � aS �•/�,�(«/ Address: City/State/Zip: Phone (w): (h): (fl�- Address: City/State/Zip: Phone (w): (h): �fl�- Please indicate with an asterisk * the contact person for this project. �B - � ?003 ; , .',1 � i'_ '.. PROJECT DESCRIP i iJN• /( � pod � G?�Qi� c.�- ��et/ a� �ia �+J p AFFADAVIT/SIGNATURE: I hereby certify under penalty of perjury that the information given herein is true and correct to the best of my knowledge and belief. Applicant's signature: ���� Date: ��+ a� I know about the proposed application and hereby authorize the above applicant to submit this application to the Planning Commission. Property owner's signature:_ ���'—� � Date: �� 0 3 Date submitted: � � �� PCAPP.FRM