HomeMy WebLinkAbout2751 Summit Dr - Application� V CiT !
�R� ��, CITY OF BURLINGAME
���� APPLICATION TO 1� PLANNING COMIVIISSION
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Type of Application:_Special Permit_Variance_Other M�� �-� ,� � A i2 F ra c��,� s; ,z ,.; � r�n�a
Project Address: -� �.�" i-_s �:.�.1,�,, � r r�,z � vE
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Assessor's Parcel Number(s): ��=�---��t--�l -
APPLICANT
PROPERTY OWNER
N3rile: .Euc�CN� L- E.�;.ivwi N1ITle: ���'�:�Nt L c+i-i�a.,�., �
Address: ��.► � � ���+.�ti, , r �� �.�� Address: -� �� s� s;�,..� �.. � � � x, � c
CitylS�te�ZlP: BCl�2lJN�-7RNE �/1 �/4c�; �. City/State/Zip: i� cl�LiPlcJA.�+'�E. , C/� `7'S`G� C
Phone (w): � s� �'-� � - cs c �� Phone (w): �: sz � °ty - �":.z �
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ARCHITECT/DESIGNER
Name: c«<; �� !- �'r+�N �v Please indicate with an asterisk * the
Address: ��� �� S UMM // o�z; vf contact person for this application.
Clty/StatO/ZlP: �ra2L�N�-��s,�c: , �ra `i v�•. �
Phone (w): E s t -a � v- o,� �
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PROJECT DESCRIPTION: ��.�,,� ��--� �,�; s r,�; F,_,.,, a,�� �,:,rs � b<<s�� ��z
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AFFIDAVIT/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.
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Applic t'�tu e Date
I know about the proposed application and hereby authorize the above applicant to submit this
application to the Planning Commission.
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Propert� wner's Signature Date
----------------------------------------------FOR OFFICE USE ONLY -------------
Date Filed: �[� Z�`� `� F�: �' 210, 00
Planning Commission: Study Date: Action Date: