SBA 1992-12378-105 CALLE ESTADO — LA QUINTA, CALIFORNIA 92253 - (619) 564-2246
~� 4ASE
NO: cI1-
CITY OF LA QUINTA FEE: $100.00
PLANNING & DEVELOPMENT DEPARTMENT
APPLICATION FOR SETBACK ADJUSTMENT
APPLICANT: Submit this form with two copies of a scaled site plan,
drawn to adequately depict the nature of the request. A nonrefundable
fee of $100 is required when the Application is submitted. Check must be
make payable to the "City of La Quinta".
If the Applicant is not the owner of the property, a letter must be
submitted by the owner authorizing the Applicant to execute this document
in his behalf.
PLEASE PRINT OR TYPE
APPLICANT/CONTRACTOR: _ �(//VJF�-� 12_ `�o-e DATE —ZVoT
—_� Z-
i0�S8 A H i00.octCONTACT PERSON (IF DIFFERENT) ✓1 �('� PHONE,
MAILING ADDRESS: ! `' �"� O e/G-- nZ z�--G 0
(Address) (City) (State) (zip)
OWNER'S NAME: fax PHONE
MAILING ADDRESS: 7q
�( do
STREET ADDRESS OF PROPERTY:
S-
ss) (City) (State) (Zip)Z!Z- A-64
-
LEGAL DESCRIPTION OF PROPERTY: LOT #
ASSESSOR'S PARCEL NUMBER:
ADJUSTMENT REQUESTED:
r
REASON FOR REQUEST:
TRACT
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JUSTIFICATION: No request for a Setback Adjustment shall be granted
unless it is determined that it is consistent with the intend and purpose
of this Ordinance; that there are special circumstances applicable to the
property, including such factors as size, shape, topography, location or
surroundings that justify the approval of the adjustment of the setback
requirement, and that the adjustment will not be detrimental to the
health, safety, and general welfare of the community or be detrimental to
property in the area of the parcel for which the adjustment is requested..
FORM.013/CS
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PLOT PLAN
GENERAL SPECIFICATIONS
Size R x to -0
Code/ 3b-410
Shape ge-6AL,9-!J4 le
-3 to " r-
Depth !,-,
f - to
Tile Color (n. 4G :Z:
Coping 12*
Cantilever
Pool Capacity
Gals.
Pump Capacity
G.P.M.
Filter C,4r,
Sq. Ft.
Pump Pto
H.P.
Fitter Rate
8:0 G.P.M.
Tumovef
Hm
Vacuum Line & Skimmer
Retum Line
Main Drain
fvc-
Skimmer 14 Aar CQ
Backwash to
Aritksyphon vawe 3],j
Heater 4,4-0 S Sim 3 2--' 0 00 B.T.U.
GaWine by S V&44-,t:VL Electric by :5 of- vq-t
Light - 2- 40 C> /- /DO
Time Clock -7-10171
Decking S &�
Boaid color
Slide Color
/7 �5 4A-
Tel
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AWmm' -71) - S S- A
CASE NO. UY'
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DEEPE ENDS
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SHALLOW
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SCALE IN"- IV'
SINCE 1974
PQ am 836
PALM DESERT CA 92261
PHONE (M% 5654OU
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