SBA 1996-388CASE NO: 3�
CITY OF LA QUINTA FEE: $100..0.0
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 i-s 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.
C PLEASE PRINT OR TYPE '
APPLICANT/CONTRACTOR: C I; 0( A, 4�., ?CIS t
CONTACT PERSON ( IF DIFFERENT) Yflr4
MAILING ADDRESS :. 7,--5-/-Z�� i-x : C A l A
(Address) (City)
OWNER'S NAME:
MAILING ADDRESS:
y v-
(Address)
DATE
PHONE
(State) (zip)
PHONE
(City) (State) (zip
STREET ADDRESS OF PROPERTY: S� e^. �-
LEGAL DESCRIPTION OF PROPERTY: LOT # TRACT
ASSESSOR'S PARCEL NUMBER:
ADJUSTMENT REQUESTED:
REASON FOR REQUEST:
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
MEMORANDUM
CASE:Z-6y W-3A;)F Locations) : 8-3io ?tea , � �a /�, Z.
Request(s) : %l ec�ic.� ,X, 4La.iJ
i
4
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: -,
TharVc you foZour cooperation.
P�
ILI
A
.c: Building and Safety Department
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79-275 RANCHO LA QUINTA DRIVE • LA QUINTA, CA 92253 • 619 777-7755 • FAx 619-777-7750
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