HomeMy WebLinkAbout1132 Bernal Avenue - Application/Ar` CIT O*
�,R�N�,� CITY OF BURLINGAME
�� �� APPLICATION TO THE PLANNING COMIVIISSION
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Type of Application: Special Permit Variance � Other M�'`^ o� M a d��i ��� d►�—
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Project Address: � I �� ��� L ��; � j lr�'!��(it� �� � �`�b�0������
Assessor's Parcel Number(s): Q �� � � � �- — � � l�
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Name: � ���GS � ���� �
Address: � V�I '
City/State/Zip: � t ��- �
Phone (w): � 5 ^� � � S �
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ARCHITECT/DESIGNER
Name: �rU,l�l"� vi�fJ ��l}'j�
Address:_�t1 � � �� �r�j�� S�',� � ���'
City/State/Zip: . ��I�l �1 C� � `lu � �-
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Phone (w): 4! �r,����j ��,c�'�'
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fax: � ��'�U � � �{�' � �a��
PROJECT DESCRIPTION: �l l�'I�� �9
AFFIDAVIT/SIGNATURE: I
herein is true and conect to (�
Applicant's
PROPERTY OWNER
Name:_ S���i£
Address•
City/State/Zip:
Phone (w):
rn�:
Please indicate with an asterisk * the
contact person for this application.
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certify under penalty of perjury that the information given
my knowledge and belief.
I know about the proposed p i on and hereby authorize the above applicant to submit this
application to the Planning Co mis
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Property Owne 's gnature Date
-------------------------------------------- - OR OFFICE USE ONLY -----------------------------------------•
Date Filed:_ ��� I�`� 7 Fee:� �2 �(�
Planning Commission: Study Date: Action Date: