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i• <br />• <br />• <br />• <br />N <br />1. Date <br />CITY OF LOUISVILLE, COLORADO <br />APPEAL APPLICATION FORM <br />BOARD OF ADJUSTMENT <br />2. *Case No. <br />To be completed by Board <br />Hearing Date 7:3d ,(1)/ti- <br />To be completed by Board <br />3'Applic"-LISNarne/I-J-->7 4 Address <br />4. Owner's Name r Cc. Address <br />• <br />5. Location of Project <br />Street Address and Subdivision Lot and Block No. <br />6. Describe request showing justification and relief sought. <br />re/ <br />-7•;• <br />• <br />/ <br />./ I"- 7 • >•--. <br />• <br />7 Provisions of the Zoning <br />application. Completion <br />• Applicant's <br />Signature <br />(.: <br />Ordinance requiring the denial of the permit <br />of this section by the Chief Building Inspector. <br />• <br />61/1?-c,-7-i4=7,-;7 <br />Re -au re..( f-r)) (M Fru A/7- 9A-rz,n <br />/4- mho kl <br />A-ce_ o .2s-to '' /4) /4- e_ L. • <br />Chief Building -Inspector <br />Note - Within 30 days from the date of application a Zoning Board of Adjustment <br />hearing will be held. Applicant will be notified of the time and date. <br />Please submit with this form all pertinent data including copies of <br />printed application, specifications and plans, as well as any additional <br />information which would be helpful in the presentation of this case. <br />