SBA 1996-397CITY OF LA QUINTA
PLANNING & DEVELOPMENT DEPARTMENT
APPLICATION FOR SETBACK ADJUSTMENT
1
CASE NO
FEE: $100.0-0
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: CG 11. ��� �� 1 DATE
CONTACT PERSON (IF DIFFERENT)
MAILING ADDRESS: _ ��� liZ-� �d t\� x�Eil
(Address) _ (City)
OWNER'S NAME:
MAILING ADDRESS: / 0 b�S � hN. LP,
(Address) (City)
STREET ADDRESS OF PROPERTY:✓
LEGAL DESCRIPTION OF PROPERTY:
ASSESSOR'S PARCEL NUMBER:
ADJUSTMENT REQUESTED:
REASON FOR REQUEST.:
PHONE
(State) (zip
PHONE ,
(State) (zip
LOT # TRACT
0
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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
I
MEMORANDUM
CASE: Locations):
Requests):�
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 justif approval of the adjustment. These
circumstances are: qe.,- .
or your coopgration.
Sin"reky,
opmen
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