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SBA 1995-330t CASE NO: 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 properi submitted by the owner authorizing the Applicant to in his behalf. PLEASE PRINT OR TYPE APPLICANT/CONTRACTOR: (C.E et(7 An�n,�4� CONTACT PERSON (IF DIFFERENT) MAILING ADDRESS: :ter must be this document r*Jul. 0 5*19*9 *1U�***** By � DATE�- PHONE Q�4— �J I. ® t -( OWNER'S NAME: �- ( A c L � , (01��L�-/t PHONE MAILING ADDRESS: (Address) STREET ADDRESS OF PROPERTY: �j� rA Adr, �4Cj225; tate) (zip LEGAL DESCRIPTION OF PROPERTY: LOT # TRACT. ASSESSOR'S PARCEL NUMBER: ADJUSTMENT REQUESTED: REASON FOR REQUEST: n ffi1 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 0 414 O&A.. M-EMORANDUM CASE: F/S-- 33p Locations): 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: , -,�� Jna_� v -e-1 ,Off; . Thank you for your cooperation. Sincerely, Attachments c: Building and Safety Department 'di V 1 APPROVED By Division By�-- 'CIA ------------ - —2—z CASE tqo.