TR-2002-07b
Application closed 11/27/02
Refund requested for application fees.
PLANNING PERMIT APPLICATION FORM
Community Development Department (408) 777-3308
10300 Torre Avenue Fax (408) 777-3333
Cupertino, CA 95014 planning@cupertino.org
http://www.cupertino.org/planning
Property Owner N r.? r -r--h p P .1'>. t- !-IIO A-
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Phone
Fax
E.mail
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Project Contact Person
Address S 0(., ~....
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Phone
Fax
E-mail
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Project Address Sa ~
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APN _ _ _ _ _ Zoning General Plan Designation
_ _ _ _ _ _ _ _ _ _ Attach separate sheet for additional APNs if necessary
Descri tion of Pmject DescrIbe In detail your proposed project. Attach separate sheet if necessary.
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Existing
Proposed
Land Use
Parcel Size Net
Dwelling Units
. Density per Gross Acre
Building Square Footage
Lot Coverage (percentage)
Paving Area (percentage)
Landscape Area (percentage)
Floor Area Ratio (FAR)
Building Height
Parking
. Regular
Compact
Handicapped
Hours of Operation
Number of Employees
Gross
Net
Gross
...
I certify tbat the foregoing statements an true and correct to tbe best of my knowledge. I understand that a m/snpresentation of any submitted data may
invalidate an approval by the Design Review Committee, Planning Commission or City Council of tllls application. I understand tbat the application may be
withdrawn if! or my authorized representative is not present at the scheduled meeting(s). or if a wrItten request for pastponement has been pnsented to the
Pianning Commission or affected nvIew board. I have discussed this applicatIon with the PubJic Works staff and I understand the pubiic improvement
requirements associated with this prop
Date /I/;,j /p~'
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e owner of said property or have Power ofAttomey (attach copy) from said property owner and tbat I consent
VLi.
vV.
Applicant's Signature
I declare under penalty of perjury that I am
to tbe above-described application.
Print Property Owner's Name
Date
Signature
Date
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Staff use only: application accepted by
Odober. 2000