HomeMy WebLinkAbout1465 Burlingame Avenue - Application� PLANNING APPLICATION
BURLINGAME COMMUNITY DEVELOPMENT DEPARTMENT—PLANNING DIVISION
�501 PRIMROSE ROAD, 2ND FLOOR, BURLINGAME, CA 94010-3997
TEL: 650.558.7250 � FAX: 650.696.3790 � E-MAIL: PLANNINGDEPT(a�BURLINGAME.ORG
PROJ CT AD / $ �S �i%_�A� / :'l' � �� /%iJ� A�E S0� P RCEL # (AP���
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ARCHITECTIDESIGNER APPLI AN
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BURLINGAME BUSINESS LICENSE #
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*FOR PROJECT REFUNDS* - Please provide an address to which to all refund checks will be mailed to:
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NAME ADDRESS
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I HEREBY CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION GIVEN HEREIN IS TRUE AND CORRECT TO THE BEST OF MY
KNOWLEDGE AND BELIEF.
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APPLICANT'S SIG ATURE (IF DIFFERENT FROM PROPERTY OWNER)
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I AM AWARE OF THE PROPOSED APPLICATION AND HEREBY AUTHORIZE THE ABOVE APPLICANT TO SUBMIT THIS APPLICATION TO THE
PLANNING CO MI 10 IDIVISION.
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PR ERTY OWNER'S SIGNATURE DAT /
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AUTHORIZATION TO REPRODUCE PLANS
I HEREBY GR,4NT THE CITY OF BURLINGAME THE AUTHORITY TO REPRODUCE UPON REQUEST AND/OR POST PLANS SUBMITTED WITH THIS
APPLICATION ON THE CITY'S WEBSITE AS PART OF THE PLANNING APPROVAL PROCESS AND WAIVE ANY CLAIMS AGAINST THE CITY ARISING
OUT OF OR RELATED TO SUCH ACTION �_ �INITIALS OF ARCHITECTIDESIGNER)
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APPLICATION TYPE
❑ ACCESSORY DWELLING UNIT (ADU)
❑ CONDITIONAL USE PERMIT (CUP)
[, li6ESIGN REVIEW (DSR)
❑ VARIANCE (VAR)
❑ WIRELESS
❑ FENCE EXCEPTION
❑ HILLSIDE AREA CONSTRUCTION PERMIT ❑ OTHER:
�MINORMODIFICATION �YY11�(1�� DS��
- ❑ SPECIAL PERMIT (SP)
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DATE RECENED: i j(�_��NNING D''-