MUP 1999-144•
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Tiht 4 44�a914(rw
DEMAND /CHECK REQUEST
Return check to requestor
Name / Title of person requesting check
JERRY HERMAN, COM. DEV. DDR,
Department individual is associated with:
Community Development
Check payable to:
Sergici Rodriguez
(Name) (Vendor No.)
55101 Monroe Street
(Address)
!,a Quinta, CA 92253
Check description and invoice number:
Mail check
FILE carr
I� JUL 8 1999
u �
Amount: $ 7 5 .
Account Number:
Project Number:
APPROVED FOR PAYMENT
(Finance Department Use Only)
BY:
BY:
ACCOUNT NO.
DESCRIPTION
of ,,n a Quinta
Date Invoice
06/17/99
&00804 •SERGIO RODRIGUEZ
Account
101 000 441 345
37453
Description
REFUND APPLICATION
SERGIO RODRIGUEZ
55-101 MONROE STREET
LA QUINTA CA 92253-
37453
06/23/99
Amount
75.00
75.00
3745.3
CHECK NO:
AMOUNT
01
-
TH051ZED SI#NAT_URE
City of La Quinta
Community Development .Department
78-495 Calle Tampico
La Quinta, California 92253
"Wou) 777-7125 FAX: (760) 777-7155
UN 0 910
0001ON FOR MINOR USE PERMIT APPROVAL
OFFICE USE ONLY
Case
Case No. '� 7
Date Recvd.
Fee: -
Related Apps.:
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
4- # # 4- 4- 4-. ♦ 4- � 4- # 4- 4-
Sir\ o ��� d u e,-7,9 3Y043K?
(Print)
MAILING ADDRESS � S ` /o/. M 0 1 r'o C- Phone No. 39? -670
10 CITY, STATE, ZIP: L (C. Fax No.I[A
•
PROPERTY OWNER (If different): 4(. &rr A n
(Pfini
MAILING ADDRESS: D 3 ^ S3 3 F,;-, -&r a � o� titin _Phone No. 3 (-l7- f� 7
CITY, STATE, ZIP: Al a Fax No.
PROTECT LOCATION: S I D( ./n 6 yl
PROPOSED
PROPOSED USE AND/OR CONSTRUCTION (Including operational information): 61 3 -Ti,
9e? o%% L i o v, bac a�
/ (attach sheets if needed)
LEGAL DESCRIPTION (LOT & TRACT OR A.P.N.): P4 e -(LI
A18%&or Use Perntit
+; SUBNIISSION REOUIREMENTS•
•❑ 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 I
❑ 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 str 0 c a L4 -4n. -
(Please Print) / G
SIGNATURE OF APPLICANT DATE
NAME OF PROPERTY OWNER AL b d- ti-, 7 �, .► �o �" 8 �� z
(Please Print)
SIGNATURE OF PROPERTY OWNER(S)
IF NOT SAME AS APPLICANT: DATE
(Signature provides.consent for applicant to use site fo pr sed activity).
1IXx #
•
(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.
A181Minor Use Permit
I
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