HomeMy WebLinkAbout2200 Adeline Drive - ApplicationCity of Burlingame Planning Department 501 Primrose Road P(650) 558-7250 F(650) 696-3790 www.burlingame.or�
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BL1R11NCiAME APPLIC ��ION TO THE PLANNING COMMISSION
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Type of application: Design Review Gonditional Use Permit Variance
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Special Permit Othe�������Parcel Number:
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Project address: ��..v�O �C�e.,,�,��2, �C ��1 e,,,
APPLICANT
'-� Name: � , t,0.r '
Address: ��O ��e..�ti�,e. �C• �
City/State/Zip:� U`��'i\ ���O�Q
Phone (w): (��A� S`�2'�l'I��
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PROPERTY OWNER ���`M'�. RS i��l.���
Name: t'�\�ke � CV.`c\�C.A.Cc�,��
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Address: �,.dO'�e,`�i�,e �S'� �
City/State/Zi�;�„ `\t�y , °1,Vt8�C�,
Phone (w): 6S0 - cS22� r1�1. 3
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ARCHITECT/DESIGNER
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Name: �o�� � . �@,.s.�
Address: ��$ �bS�.v.0.
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City/State/Zip:��'c��y vct,�e � y�08i6�-'
Phone (w):1•�t08� `132.,-��53�sZ1
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Please indicate with an asterisk *
the contact person for this project.
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J U L 1 4 2003
CITY OF BURLIIVGAME
PLANNING DEPT.
PROJECT DESCRIPTION: �c'C���� f'e���� �
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. r
Applicant's signature: Date
I know about the propose applica ' hereby authorize the above applicant to submit this
application to the Planning C ' ion. /
Property owner's signature: C-�C�Gl�..� Dat
Date submitted: � y o
PCAPP.FRM