HomeMy WebLinkAbout2760 Burlingview Drive - ApplicationC�0�7 Oo � [�MQ��I�]C�
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jjrne of ARnlication: Special Permit Variance Othe
Project Address 2��j�.l I�L I N6Y I El�l i�l�l� �
Assessor's Parcel Number(s) �2�— ��I " � Iv
Name: � 'I rr�a vrru
Address: � ��� ��k
City/StateRip: �
Telephone:(work) �� 5'
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(home)
ARCH/TECT/DES/GNER
Name: �G� � � �
Address: �
City/State/Zip:
Telephone (daytime): "
PROPERTY OWNER
Name: �� � . � " � '
Address: ��
City/State/Zip: °�� � G
Telephone:(work) ��' � �^�D� �
(home) ;t1����.-'�DI�
in i wi h n ri • h n
is for ihis nroiect. ///� I I I�'i.�9�1 I
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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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ant's Signature Date
I know about the proposed application, and hereby authorize the above applicant to submit this
application. � 18 �3
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Property Owner's Signature Date
OFFICE USE ONLY -----------------------------------------------------
Date Filed: �e .` �� Fee c�-1 �� Receip�-#
Letter(s) to applicant advising application incomplete: °
Date application accepted as complete: �
P.C. study meeting (date) P.C. public hearing (date)
P.C. Action
,2rss Appeal to Council7 Yes No
a�;�.rn„ Council meeting date Council Action
AFF/DA V/T/S/GNA TURE: