PP 1995-558 Amend #1Fee:
REQUEST FOR MODIFICATION OF AN APPROVED
RESIDENTIAL & COMMERCIAL DEVELOPMENT PLOT PLAN
Please complete this application form. The fee to process this request
is $3*egso0.
On a sepEirate sheet of papE>r explairi the
modification requested siting t:he condition or
regulExtiorn to be changed
Plot Plan Number Cl 5 S
Location /Address
Assessor's Parcel Number
Section /Township /Range
Applicant's Name
RMS
Mailing Address f�Q ex�:)DC 17; V"C LW- !E ^111j25
Phone: , lo1�t) �3-�y3c7
Signature
Owner's Name
Mailing Address
hone:
Signature
TWO 4f4 4 a"
78-095 CALLE TAMPICO - LA QUINTA, CALIFORNIA 92253 (619) 777 -7000
G FAX (619) 777 -7101
245 c - Date Received Cl
Received By — f �
jl��
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253
FORM.018 /CS