MUP 2001-2780 st
City of La Quinta
Community Development Department
78-495 Calle Tampico
La Quinta, California 92253
(760) 777-7125 FAX: (760) 777-1233
OFFICE USE ONLY
Case No. Q%— -2.78
Date Recvd., L o /
Fee: 7 � '
Related Apps.:
Logged in by:
APPLICATION FOR MINOR USE PERMIT APPROVAL
MINOR USE PERMIT applications are reviewed and approved by the Community Development Director
pursuant to Section 9.210.020, of the Zoning Code. The purpose of the review is to ensure that land uses requiring
the permit do not have an adverse impact on surrounding properties, residents, or businesses.
+ + + + + + + +
APPLICANT 'L
(Print) (�
MAILING ADDRESS '-5t250-0 �i f A(yt O2 Phone No.
CITY, STATE, ZIP: 0 � A --F> t S �- Fax No.
PROPERTY OWNER (If different): -"
(Print)
MAILING ADDRESS: Phone No.
CITY, STATE, ZIP: Fax No.
PROJECT LOCATION: 41� q -cry N i Y J A -J Ort- r Q
PROPOSED USE AND/OR CONSTRUCTION (Including operational information):
LEGAL DESCRIPTION (LOT & TRACT OR A.P.N.):
c
MR t.00i
"'IT Y tit- LA U091
A I Minor Use Permit
SUBMISSION REQUIREMENTS*
❑ Plot Plan, floor plans and elevation plans (as determined by Community Development Department staff).
Five (5) sets of plans on 8'/2" x 11" sheet or folded down to 8'/z" x 11".
❑ Filing fee for Minor Use Permit. If filing multiple applications, the most expensive application will be
charged full fee, with remaining related applications discounted 50% for each. This discount does not apply
to Environmental Information form.
NAME OF APPLICANT
(Please Print)
SIGNATURE OF APPLICANT J DATE 3—/-- /
NAME OF PROPERTY OWNER '00/r*i/Lc,
(Please Print)
SIGNATURE OF PROPERTY OWNERS)
IF NOT SAME AS APPLICANT: DATE
(Signature provides consent for applicant to use site for proposed activity).
DATE
(Separate written authority by owner to submit application may be provided)
NOTE: FALSE OR MISLEADING INFORMATION GIVEN IN THIS APPLICATION SHALL BE
GROUNDS FOR DENYING APPLICATION.
A 1Minor Use Permit
Twit
"
DEMAND / CHECK REQUEST
CF's OF
Return check to requestor Mail check
Name Title of person requesting check
Department individual is associated with:
Check payable to:
i! i.3.kev Roil ei- S
(Name) (Vendor No.)
(Address)
Check description and invoice number:
Amount: $ % =' • C
Account Number:
Project Number:
Re. -'f ,, nvj Of M inor vs E_ Pe rm : - .;JL i c,i C7n f i I
,,,3 f F
D /a0
MAS? 2-.1 2001 �
Signa;ure:
Department ea
ate
_
Citi o//���� • 44497
o�a (o�uinEa &01340 4kIKE ROBERTS 44497 03/13/01
Date Invoice
03/09/01
Account
Description
REFUND MINOR USE P
PAY TO THE ORDER OF:
MIKE ROBERTS
31-300 DESERT PALM DRIVE
THOUSAND PALMS CA 92276 -
Amount
75.00
75.00
44497
CHECK NO.
DATE AMOUNT
03/13/01 *********$75.00
1/7 AUTHORIZED9GNAT f