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Home My WebLink About2753 Burlingview Drive - ApplicationCity of Burlingame Planning Department 501 Primrose Road P(650) 558-7250 F(650) 696-3790 www.burlingame.org �` c�rr o � BURLINGAME APPLICATION TO THE PLANNING COMMISSION �� Type of application: Design Review Conditional Use Permit Variance Special Permit Other Parcel Number: Project '�75� �-a APPLICANT , Name: � I / Z �+` Address: ��% 5 5 �_>t� ': �� City/State/Zip: � '� �i ��= c;' � Address: Phone (w): � �-`h): � g�� L�� 5�/ �� ° ��- �G � � ARCHITECT/DESIGNER Name: �,.-� e � v � �. ti� Address: � � � � , . .� �J , � � 5_ City/State/Zip: �� C� h—i � ��o c- S�� , Phone (w): � �`' ' + � � . �h)� ��_S ~ _ �� ' c�: %`I ( /��/ / PROJECT DESCRI�jTION: � � �1Pi� rN1 t 't� � �-� � c�`-=> � � �o� r— City/State/Zip: Phone (w (h): �fl� � � `ti � l�/.-� C�-� U� Please indicate with an asterisk * the contact person for this project. RECEIVED OCT 2 6 2005 CITY OF BURLINGAME PLANNING DEPT. �-'� ��' � r �� t� T�(�(.iC �-� U . � AFFADAVIT/5IGNATURE: I hereby certify under penalty of perjury that the information given herein is true and correct to the best of my knowledg� and belief. � - .� , � � �� n Applicant's signature: � �� `t '� � � �-'�- / � , � � Date: � �' ;� -� , � /� � , I know about the proposed application and hereby authorize the above applicant to submit this application to the Planning Commiss�on. � � �:�L �-Z� ' � C� � �� Date: C� Property owner's signature: � �`'�� J / '� Date submitted: l� � �° � , -P ��- � � �" PROPERTY OWNER O.�r�; r' Name: S 9� v�� -�' PCAPP.FRM