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HomeMy WebLinkAbout2717 Burlingview Drive - ApplicationCity of Burlingame Planning Department 501 Primrose Road P(650) 558-7250 F(650) 696-3790 www.burlin ag me.org ���, CITY O� BURLJNCiAME APPLICATION TO THE PLANNING COMMISSION ��.m.�wesi� . Type of application: Design Review Conditional Use Permit Variance Special Permit Other��Parcel Number: � 2'� -- 26 �-� �1 [7 Project address: Z� � 7 ���-�-� �% � v��-�% �-y1 [ ✓4� APPLICANT Name: c�7�N �/� Address: �� C.C/e-��- ��.�' City/State/Zip: �S'� �v�+/YJ+�, C�' Phone (w): 6 ST� ��S �6 �� __ � �d � � (h): � ; � J� � 7 3 - `fJ-6 � RCHI � /DESIGNER Name: ���� � ����' Address: City/State/Zip: Phone (w): (h): i�:- PROJECT DESCRIPTION: / N�' l c� �' �nJ �c AFFADAVIT/SIGNATURE: I hereby certify under penalty of perjury that the information given herei� is �ru�nd correct to the best of my knowledge and belief. A Date: l � � D y I know about t�ie proposed application and hereby authorize the above applicant to submit this application to the Planning Comm� ' n. Property owner's signature: Date: lc��� �a Y Date submitted: �' 30 • 02._ PROPERTY OWNER Name: tiC�2 � r��I' �0 i�-vS 2f�,�,2rh/,� Address: 2r7 �'? �v' �J�-t n�� t/� `�I �rl City/State/Zip: �% dru . � �d !'v Phone (w): �n�� � `� z � 3 `� 2y (�� Please indicate with an asterisk * the contact person for this project. RECEiVEC� SEP 3 0 2002 CITY OF BURLINGAME PLANNING DEPT. � rJ � � iU J (1 %� �.�t.r�t c G� �dYL PCAPP.FRM