HomeMy WebLinkAbout1448 Burlingame Avenue - Application1
�URLINGAME
COMMUNITY DEVELOPMENT DEPARTMENT • 501 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
❑ Conditional Use Permit
❑ Variance ❑ Parcel
❑ Special Permit ❑ Other:
.
PROJECi ADDRESS: 1 �'�'8 �I�}�{IIiC/Gi1� �'-1V`�'n�.Z�
APPLICANT project contact person ❑
Payor of DSR deposit/handling fee ❑
OK to send electronic copies of documents ❑
Name: l.a��l/�-L %,� 1� fl1Gy f.�
Address: l � � ���� 1��
City/State/Zip: �����n��1 � ✓-`��U
Phone: � ��• ��� � d7 �7
Fax: �3�d� �7�t� •�(�r70
E-mail: GQ'�' ��11w C°7 n I�iYl�yU�• GGf'?�
1 n �uY�.e.
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PROPERTY OWNER project contact person ❑
Payor of D5R depositlhandling Fee ❑
OK to send electronic copies of documents ❑
Name: ��T}� ��O c� \ '� ��'�
Address: �� 5 d v� � n �
City/State/Zip: � -� � L
Phone: �=Z - ��. (, - �' 2 6 C.
Fax: ----
E-mail: _�- v-4'�•• t,�o � i s c� o�. O►N1t� f. Ca►.�
ARCHITECT/DESIGNER project contact person ❑
Payor of DSR deposit/handling fee ❑
OK to send electronic copies of documents C7
Name: �(�+ Ct� Ol.bOv�
Address:
City/State/Zip:
Phone:
Fax:
E-mail:
�k Burlingame Business License #:
PROJECT DESCRIPTION: �P
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AFFADAVITISIGNATURE: 1 hereby certify under penalty of perjury that F
best of my knowledge and belief.,, `
i
Applicant's signature: ���,i
I am aware of the proposed application a e y au orize the ap
Commission.
Property owner's signature: /���
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st�d�nK ddus
given herein is true and correct to the
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I Date-
to submit this application to the Planning
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