HomeMy WebLinkAbout2104 Broadway - Application" COMMUAfiY DEVELOPMENT DEPARTMlNT • 3p� p�MRO�E ROAD � B(lRLlppqME� CA �O'I O
p: BSO.SS8.7�0 • f: 650.866.5790 • www.burltnparr�.orp
APPLICATION TO THE PLANNING COMMISSIQN
Type of applicatlon:
I� Design Review ❑ Variance p
� Conditionel Use Permft ❑ gpepe� permit ❑
PROJECT ADDRESS: 2 � Q 4� r� c1 � �v c� �
APPLICANT
Parcel #:_Q27-34 -070
Zoning / Other. -----
Name: �eanne Davis
Address:
Ciiy/State/Zip; Burlinaame _A �arnn
Phone: _C626) 4 -4197
E-rnail: ' anneCa�davis-arch com
ARCHITECT/DESIGNER
Name: _(Same as aoolicant)
Addross:
City/Stete2p:
Phone:
E-mafl:
Burlingeme Business Lfoense #:_ 27455
PROPERTY OWNER
Name: Lesley and Derek Bowler
Addr688: 2104 Broad�;sv
City/StatalZlp: B�(jraama. r'n 94010 +
(41�) 279 88 es ey
Phone:
leslietay or owler@gmai .com
E-fY18il: dQrek_h„�.�le.�...r,:� __m
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I h�r+oby prarlt the City ot Burlin�am� the suthorrtr to roprpquq upon nqwst andlor poat pl�na �ubmittrq with thit
application on tho City�a rwb�i� �� p�rt pt th� Planninp �ppruva� pro���� ��d ��� any olalms ap�lnst th� City
arisln� out of or nlated to such �ctlon,
(Initials o/ Ar,chit+�cf/D�alpner)
PROJECT
�
�w-FioAVIT/81GNATURE: I hsreby certiy undar p�snaHy of perj�,ry that tha Information elven horoln ia trua and correcf tp ths
best of my knowledge and bsli�f. (
ApplicanYs si�natun:_ , �,J � ', C �
I am aware ot the ro �a' '
P poaed applicatlon and hareby authorize � a�e applicant to �ubmit thls ap Ifcation to the PlanninQ
Commiasion.
Prop.rty ovrn�rs slpn�tun: ,
D�b: � 3 Z. 01
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