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HomeMy WebLinkAbout2813 Trousdale Drive - Application���� (�) GOMMUNITY DEVEI.OPNlEI�I7 I�EPAKTMENT • 501 PRIMROS� ROAp � BURUNGAME. CA 9a010 �INfji [ p; 65U.5S8.7250 • f: 650.696.3790 - Www•burtinaame.org APPL�C,+o►TI�N TO TH� PLANIVING COtVrMiSS�ON Tvoe of appllcation: � — , Des(gn Review � Variance ❑ P�rcel #: D� --D1'Z� 30 , O Cond"ftional Use Permtt C1 Specia( Perrnit �, Qthc�r: PROJEGT ADDRESS: �$ \ �� v"Qc.�gda-� � `��`��- � Please i�diCatd tl�e oont:�ut ye��on tor tn�s proJect APPLtGANT pmjeat contaai p�rson j�i PROPERTY OWN�R projeck contsct person ❑ pK to aend e�acvonla cvples of dvcuments ❑ ,Q K co send electronlc cop[w of tlocuments � C�p� �o sc�w C�� �D� �ao W�al 1 Name: � +�u�. S�4.,.-0 �.v► c Name: h Address: ,y\�1 l,J e� ��' � 1 '� � �L . Address: _a 8 l ^iro ��a� �w; � City/State/Zip: �- � 1N1�s, C lg a�-�-�3 City/State/Zip: G� � Phone: �SD - 3�i l - �v�.Di Phone: `'� -_ — �� �ax: t��D -�'�'� l -15 3 `b �-mail: � � - ARGHiTECT/DESIGNER project contac� per9on ❑ OK !o send wlactronic coples of ducNment6 ❑ Name: S iq,a� 4: c.,�.w'� Address: - CitylStatelZip: phona: . Fax: E-mai{: '+k Buriin�ame Buslness Licet i�e� PROJECT DESCRIPTION AFFADAVlT/SIGNATUR�: I hereby certify under pc�nslty of perjury that the information given harefn Is true and correct to U7e best of my knowied�� ar�d belfaf. Applicani's signature: Data: �' A I am aware of Ehe proposed application and hereby authorize the above applic2nt lo submtt t�is �pplicetlon to the Plannin� Commiss►on. ��� ^ Property owner's signature: ,6��=� ��� Date: 4' � 6 �"� Date st�bmitted: Fax: E-m�►ll: �-su _, aG`..0 ' 98�04� 16� 09�30�` �� (�) 01 �k Verifcation that the project architecUdesigner has a valid Burtingame business license wtll be required by !he , ��nance Department at the tlme application fees are pald. "°"'' ' �� � o Please mark one box abova with an X to indlcate ti�e contact person for ehls prvJeec- S:wande,ute`��'x+'��,�qia�4����-��e^�aut i -d 6599�L�9 OS9 ptn¢Q dgg:Zi 6Q EL �di iVIA� � f� Z009 ',�TY OF t���R! iNGI`�,��14 �+,A�lNlf�lC< DE° r ��� �� � `�C� ����� S'� "�L�� � �L� ����