HomeMy WebLinkAboutAdministrative Reviews ARX1970002 - Signed ApplicationGOAD OF ZONING ADJ T
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A',0LICATIONFOR
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CITY OF HUNTINGTON BEACH
P. O. BOX 190
APPLICANT OR AGENT
MAILING ADDRESS
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PROPERTY OWNER
MAILING ADDRESS
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w DATE '`FILED
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ILI0BOARD,ACTION DATE
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® CONDITIONALLY APPROVED
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COMMISSION ACTION DATE ---
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o ® APPROVED WITH CONDITIONS
OTHER THA N BOARD'S0 DENIED
® WITHDRAWN
EFFECTIVE DATE
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INTERSECTING STREET.
LEGAL DESCRIPTION c-7 /Q a p)
SIGNATU E OF PROPER Y OWNER OR AUTHORIZED AGENT
THE ATTACHED SUPPLEMENTAL SHEET MUST BE READ AND SIGNED BY THE APPLICANT
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A) STATE REASONS FOR THIS REQUEST. ,.
FILL OUT COMPLETELY (IF MORE SPACE IS REQUIRED ATTACH ADDITIONAL PAGES)
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B) STATE LENGTH OF TIME REQUESTED FOR USE.
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