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SBA 1995-285e CASE NO: CITY OF LA QUINTA FEE: $100.00 PLANNING & DEVELOPMENT DEPARTMENT APPLICATION FOR SETBACK ADJUSTMENT APPLICANT: Submit this form with two copies drawn to adequately. depict the nature of the fee of $100 is required when the Application is make payable to the "City -of La Quinta". of a scaled site plan, request. A nonrefundable submitted. Check must be If the Applicant is not the owner of the property, a letter must be submitted by the owner authorizing the Applicant to. execute/t,,his document in his behalf. APPLICANT/CONTRAC CONTACT.PERSON (I MAILING ADDRESS: OWNER'S NAME: �(�, (�Yb�.i��Y PHONE MAILING ADDRESS: s City State) (Zip) I STREET ADDRESS OF PROPERTY: 79— S�t flyio jFiC xv4-i , r, 4 , LEGAL DESCRIPTION OF PROPERTY: ASSESSOR'S PARCEL NUMBER: LOT # 17 TRACT ADJUSTMENT REQUESTED: 3o S ids. y1peo -5o4& � '17iZ fm©L . REASON FOR REQUEST: 4"o,," !! j! 4c�e TV 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 _ _ •" jam• :. �. APPROVED BY PLANNING &.DEVELOPMENT DEPARTMEN BY ;-DATE EXHIBIT - CASE NO. 3' nAe,; t. i P6 ,pool �r6 jGtcictjAV-A- onl for ..— I„ T uIp •��. 1 ROSY � -NCa, CrAU'US P:�l.U �,��c� �U�iGuB62C K �- A3wQI 1IDT 1 -7 kA Q