HomeMy WebLinkAbout2645 Trousdale Drive - ApplicationBURIJNGAME
COMMUNITY DEVELOPMENT DEPARTMENT • 5O1 PRIMROSE ROAD • BURLINGAME, CA 94010
p: 650.558.7250 • f: 650.696.3790 • www.burlingame.org
APPLICATION TO THE PLANNING COMMISSION
Type of application:
,:..� Design Review ❑ Variance
❑ Conditional Use Permit ❑ Special Permit
PROJECT ADDRESS:
APPLICANT project contact person ❑
OK to send electronic copies of documents�
Name: `�- ��l �1 L.1 �
Address: `Zl� �' � � � � )� i �/a,�,19 � �
City/State/Zip: I�� I,� h(,�/.�, �1 �� �/a q'�(Z� �
Phone: � � � f�� Z� �1 -� � � ���-
Fax:
E-mail
/DESIGNER project contact personJZi�
OK to send electronic copies of documents�
Name: �J �1�/ 1 � .12 `�C7 �i., i� :� 7.,A �
❑ Parcel #: � 2 "J � Q �7 Z " � � 0 �y
❑ Other:
PROPERTY OWNER pro)ect contact Person ❑
OK to send electronic copies of documents ❑
Name: ��k,►!'�1 �` � S � �' � j� -
AddrE--�
City/�
Phon�
Fax:
E-ma,..
�
Address: �%12 � �� �- i ��' � '��
City/State/Zip: � A;,.� �(�-/a � c:, j�<<�, C�A ��I, �t � 1 D
Phone: C � `� �J1 � Zq' ' � ��
Fax:
,_--
E-mail: J G- � 1 P,r ��� D�0�1' ��!'� � n C� , C�1'JW� �
* Burlingame Business License #: G 1�' l�
PROJECT DESCRIPTION:
i2 f� f7'w= � _1 ►� � .
u� � � � •� ° � �"`ti'
���� �� ��
APR 11 2U12
CITY OF BURLINGAME
CDD-P!...P,NNWG JiV
► . , , � ,�-�
AFFADAVIT/SIGNATURE: I hereby certify n er penalty of perjury that the information given herein is true and correct to the
best of my knowledge and belief.
Applicant's signature: Date: i J i 2,
I am aware of the proposed applica,ion and hereby au horize the above applicant to submit this application to the Planning
Commission.
Property owner's signature: ��� ] Date: ��i �� I Z
Date submitted:
yt Verification that the project architect/designer has a valid Burlingame business license will be required by the
Finance Department at the time application fees are paid.
5: �HANDOUTS�PCApplicotion.doc
1� ���y�.G`� �^" �� �
� �.( ,, ��VVV�'vi/�
`��C�
�- �/1/� ��n e � f 1/� � G� .. � G• � S � �