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SBA 1995-302CASE NO.: X-50 Z CITY OF LA QUINTA FEE: $100.00 PLANNING & DEVELOPMENT DEPARTMENT APPLICATION FO 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 this document. in his behalf. PLEASE PRINT OR TYPE 4R 2 g 19 APPLICANT/CONTRACTOR: CAa2�L2tA- Q 60b IAA DA S' CONTACT PERSON (IF DIFFERENT) MAILING ADDRESS: kf IR(O yry 1. (Address OWNER'S NAME - MAILING ADDRESS: City State) (Z PHONE (Address) (City) (State) (Zip) STREET ADDRESS OF PROPERTY: LEGAL DESCRIPTION OF PROPERTY: LOT # TRACTTNE,�S Fl ASSESSOR'S PARCEL NUMBER: ADJUSTMENT REQUESTED: 3►r0% REASON, FOR REQUEST: 0� KIL c%W 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 16 7 MEMORANDUM CASE: ' 3a'L Location (a) Requests) : (A5WZ Your setback adjustment application is hereby approved, -subject to the following conditions: Conditions: 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: �.lL 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: Thank you for your cooperation. Sincerely, Community Development Department Attachments c: Building and Safety Department