HomeMy WebLinkAbout1537 Cypress Avenue - ApplicationCity of Burlingame Planning Department 501 Primrose Road P(650) 558-7250 F(650) 696-3790 www.burlin ag me.org
`; ITT 01
WRLM19 ME APPLICATION TO THE PLANNING COMMISSION
Type of application: Design Review Conditional Use Permit Variance
Special Permit Other Z Parcel Number: O 2 I> - 501- Z4z---)
Project address: It&57
APPLICANT
Name: �ovrEi-{-�vr`ey �.s�c.:�es, �v►�.
Address: 25
City/State/Zip: 9 410
Phone (w): G 5b '�'7 3 3�3v -• 3l
(h):
(f): 6E)e 3�Ib -053 - 5
ARCMTECT/DESIGNER
Name:
Address:
City/State/Zip:
Phone (w):
(h):
PROJECT DESCRIPTION:
AFFADAVIT/SIC
given herein is true
Applicant's
I know abo the
application to im
Property owner's signature
PROPERTY OWNER
Ke.-bey At•1,�A�h
Name:_ecL,a,hce
Address:1533 CyP�gs
City/State/Zip:
Phone (w): --
(h): 6SD - 504.—an 12-
cfl: -
Please indicate with an asterisk *
the contact person for this project.
RECEIVED
NOV 222004
CITY OF BURLINGAME
PLANNING DEPT.
�T �oVs-fp1
I hereby certify under penalty of perjury that the information
to the best of my knowledce and belief.
Date:. in i)o✓
icatibn and hereby authorize the above applicant to submit this
Date:
bmitted:
PCAPP.FRM