PP 1994-541, Amend #14
78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 - (619) 777-7000
FAX (619) 777-7101
Fee: -$ ?g C) CK0
Date Received o - - -9 ;�
Received By
-*I
REQUEST FOR MODIFICATION OF AN APPROVED
RESIDENTIAL & COMMERCIAL DEVELOPMENT PLOT PLAN
Please complete this app'.ication form. The fee to process this request
is $380.00.
C:)Irx Ex Er.C--]PExr- Ex shee of ]PEX]Poex- ca-:7 - t I C--
rr]Lc> C11rTL4--Ex re que s t ed Er.1 - 11:1 - x4a 4--C3x or
regu]Lation to be changed _
Plot Plan Number
Location/Address Parcel Number
Sedtion/Township/Range
Applicant's Name
Mai I ling Address 15`95 �'O(Yjlj -D W)RW
raro CIA
Phone: (1 GO
Signature A ✓ T!-
M� W +-o
Owner's Name
Mailing Address
Signature
r r
Phone:
J.
MAILING ADDRESS P.O. BOX 1504 LA QUINTA, CALIFORNIA 92253
FORM.018/Cs
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