PP 1986-295CITY OF LA QUINTA A
Department of Community Develo COMMUNITY DE A QQ UIN A DE
78-105 Calls Estado
La Quinta, CA 92253
Case No. 4n�
Date Received
PLAT PLAN APPLICATION
In order to process your application in a timely manner, please
complete and sign this form. The information Which is required to be
shown on the plans is stated on the attached Plot Plan Checklist.
Failure to provide the required information is justification for
rejection of the application.
THIS APPLICATION MUST BE- ACCOMPANIED Br A NON - REFUNDABLE FILING FEE
OF $ �(u Q , COPIES OF A COMPLETE AND ACCMUTE PLOT PLAN
AND S "SETS 9z ELEQATIONS AND FLOOR PLANS. t Se- ^/, l' 6 atr
Dame of Applicant .641V — 4G�i� Phone
Mailing Address 7 � ZLCC A /ti + AMIVW 416 j ,� �/ryE',s' C1 f O/
Street' City Zip Code
Legal Owner y L. d - 4 , V,r
Address
Proposed Use d g?y�&"
Location of Property (Address if known) Co,e4/e (' , 2 f a
Assessor's Parcel Humber
Legal description of property (Give exact legal description as recorded
in the office of the County Recorder) - (May be attached)
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C/ iv i7' /
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Signature of Applicant _ C�11 Date
v
Signature of Owner Date 7 ��
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