PP 1996-582v'
•
19 ` CITY OF LAQUINTA
LANNING & DEVELOPMENT DEPARTMENT
78 -495 CALLE TAMPICO
LA QUINTA, CA 92253
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Case No.: JD Z
Date received:
Fee: _125
In order tolprocess your application in a timely manner, please complete and sign this form.
The information which is required to be shown on the plans and submitted with the application
is stated on the attached information sheet. Failure to provide the required information is
justification for rejection of the application.
THIS APPLICATION MUST BE ACCOMPANIED BY A NON- REFUNDABLE FILING FEE OF ;
i
AND __/ COPIES OF THE COMPLETE AND ACCURATE PLOT PLAN, LANDSCAPE PLAN AND ELEVATIONS.
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Name of Applicant:
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Phone: 56
Mailing Address: - 7
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(Street)
(City)
(State) (Zip)
Legal Owner: (, c! (
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Address:
(Street)
(Ci ty)
(State) (Z p)
Proposed Use: &j
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The net and gross square footage for each
proposed use and building:
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The square footage allocated for sidewalks /walkways, parking, landscaping, and building:
Location of Property (Address if known): 4`7 -3jt!9' V � CJw 0. 4 gzz,s3
Assessor's Parcel Number: 6 q3 -i vc -cog
Legal Description of Property (give exact legal description as recorded in the office of the
County Recorder) - (may be attached):
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Signature of Applicant: Date: ¢
Signature of Owner: Date: