SBA 1995-310tSE NO: Is, - 3i<2�,
CITY OF LA QUINTA
PLANNING & DEVELOPMENT DEPARTMENT
APPLICATION FOR SETBACK ADJUSTMENT
FEE: $100.00
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 m�`
submitted by the owner authorizing the Applicant to execute this;d
in his behalf. V�
APPLICANT/CONTRACTOR:
PLEASE PRINT OR TYPE
r Th �v S
CONTACT PERSON (IF DIFFERENT)
MAILING ADDRESS:
P)
OWNER'S NAME: ��'/�i�-k" iV / PHONE
MAILING ADDRESS: 5 13`
Address)
1 czya if✓6 k _ 41u CO -hq. c,
City) (State) (Zil
STREET ADDRESS OF PROPERTY: S — �%Q 4 t1_e_ act j/etfVO
LEGAL DESCRIPTION OF PROPERTY: LOT #
ASSESSOR'S PARCEL NUMBER:
TRACT
REASON FOR REQUEST: c-) I (f `r r 5Q r & &,-Y �u s "lro pvl rJ 4t)( 5�.�, dn h► ; n ,
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
Twit 4 ou 44,
MEMORANDUM
�y - a ,b - °�s
CASE: CIS - �jto Location (s) : Sa - arl o
Request (s)-t-.resw—
S� 7_
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:
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:141phla s",
Thank you f or.your cooperation.•
Silr ere
lopment Department
Attachments
c: Building and Safety Department
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SCALE: APPROVED BY: DRAWN BY
DATE:. REVISED
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