SBA 1995-301CNSE NO: 57 �o
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 $100 is required when the Application is submitted. Check must be
make payable to the "City of La Quinta".
If the Applicant is not. the owner of the property, a letter must be
submitted by the owner authorizing the Applicant to execute this document
in his behalf.
PLEASE PRINT OR TYPE
APPLICANT/CONTRACTOR: /��$�S�jgS DATE 3—,23
CONTACT PERSON (.IF DIFFERENT) PHONE 4CV- 4600
MAILING ADDRESS,:.
Address
OWNER'S NAME:
MAILING ADDRESS:
(Address
17
City
State) (Zip
PHONE
City) (State) (Z
STREET ADDRESS OF PROPERTY: q(?- V Pf+sD'jTE!^1�Gb L �
LEGAL DESCRIPTION OF PROPERTY: LOT # 3l TRACT
ASSESSOR'S PARCEL NUMBER:
ADJUSTMENT REQUESTED:
REASON FOR REQUEST:
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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
MEMORANDUM
�- 23 -�1S
CASE: aS - Location (s) : g_
Request(s):
Your setback adjustment application is hereby approved, subject to
the following conditions:
Conditions:
• J
.1. Obtain a building permit from the Building and Safety
Department.
2. The other Zoning Code provisions shall be met.
3. If ground excavation is required, please contact Underground
Service Alert (USA) at 1-800-422-4133. The service is free of
charge provided USA is given at least two working days'
notice.
4. Additional Conditions:
After review it was determined that:
1.. This adjustment is consistent with the intent and purpose of
the Zoning ordinance.
2. There are special circumstances applicable to the property,
including such factors as size, shape, topography, location or
surroundings that justify approval of the adjustment. These
circumstances are:
Tha,M&,you for. your cooperation.
Si
Department
Attachments
c: Building and Safety Department