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Home My WebLink About717 Vernon Way - Applicationeceived Fax : F1ar-28 2007 4:SOP 03/28/2007 15:16 6506963790 PAGE 07/12 Clty of Burlingame Planning Department 5D1 Prlmrose Road P1650) 558•7250 F(950) 696-3780 vn� burlinqame.o , � qpPLICATION TO THE PLANNING �OMMISSION . � . !G E � �••-•'' �/ Variance Conditional Use Permit — Typo of application; Dh51gn R�V�eW ^ Other ('arcel Number: �� q��2 �� Special Permit — Project address: 7� � v�� ApPLICANT proJe�t contacf person9� Name: A9��/K . ��1� Address: // S �� t0�-1 1T City/State/Zip: Sf�iV ,�.�fi/V�s�-r ��--� Phone (w):�� O c,ell (�:, 4/S. !I/3 O/�9 (fax):�?rSS � y — S� (e-mail): e�/Q�� ARCHITEC7IDESIGI'�IER proJect contact persoM � Name: DA�V��L �_ EW�'fl Address: City/StatelZip: � Phone (w):._ —�{� ih)�----� (fax): (e-mail); PROPERTY OWNER Projeet eontact per�o�7 �� Name:_�"'�'� S�6eck �JP,Nw� r+e�•. Address: '1� i ON l!/ y City/5tate/Zip: $l��N�N�� Ola Phone (►�'J' �� S• 2 ..�/ (fax): (e-mail): b �aeci`�' � COI'VlaL�� Please mark one box with O to indicate the contact person for this project. PROJECT DES�CRIPTION:^ � �Nfl ��¢� �D �� ra�inoN AFFADAVITISI�NATURE: I hereby certify under penalty of perjury that the information given herein is Yrue and correct to the best of my knowl ge and belief. ApplicanYs sign�ature: � ,(� �ate: �P• � �7 1 know about th� proposed application and hereby authorize the above applicant to submit this application to the PI nning Commission. Property owner's signature� Date: �/• ��.�,��'k°€�� Date submitted: � �: � S:\Hendou cS�PCAPP. F RM ''I , dri �idiiv �T� � � CiT, _ !='U-..`:I�i'id�:�� ;�r I. � �� -- �s� � Z �� -�� (L�S,=� . 5-��-� ,��z��