PP 1986-360r
., RECEIVED
CITY OF LA QUINTA AUG 19 1 1 , 11 1 166
Department of Community Development
8 - Ci elle EetadO CITY OF LA QUINTA
Z S COMMUNITY DEVELOPMENT DEPT
La Quanta, CA 92253
Case Ho. !�% u6 - 3 6- C'
Date Received
PLAT PLAN APPLICATION
In order to process your application in a timely manner, please
complete and sign this form. The information which is required to be
shown on the plans is stated on the attached Plot Plan Checklist.
Failure to provide the required information is justification for
refection of the application.
THIS APPLICATION MUST BE ACCOMPANIED BY A NON-REFUNDABLE FILING FEE
OF '$ , 3 COPIES OF A COMPLETE AND ACCURATE PLOT PLAN
AND SETS OF ELEVATIONS AND FLOOR PLANS.
-----------------------------------
Name of Applicant AJDKW �AQV W. Or CA. 6 &4 Q'
Mailing ling Address 1b 49OX L()a J-4 QQl NIA CA X=
Street city Zip
Address
Proposed
Location
M
Assessor's Parcel Number - 710 1 W - E
Legal description of property (Give exact legal description as recorded
in'the office of the County Recorder) - (May be attached)
Signature of Applicant
Date
Signature of Owner Date
O' IS ',B �P
A6213 8 19
75.00 TL