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1. Date <br />3. Applicant's Name <br />4. Owner's Name <br />CITY OF LOUISVILLE, COLORADO <br />APPEAL APPLICATION FORM <br />BOARD OF APPEALS AND ZONING ADJUSTMENT <br />/f7f <br />2. *Case No. <br />mod. <br />To be completed by Board <br />Hearing Date <br />To be completed by Board <br />/�/a� 4 <br />Address dfip'1 4eetept� <br />Address ,1:JQIOLLQ/ <br />/d47 7,ta/ ALe �f1�v�c C ,C�i/r'2Gt'a <br />5. Location of Project ,•-5/!� /V%/W 3 v4r..tcJ 1 klflil art Street Address and Subdivision Lot Block No. <br />6. Describe request showing justification and relief sought. <br />7 a 4idS, 4\ / <br />d/6z. p. / CYcc� jOttep /(v /66 G'PZiel/sf_ '0 `Lc+tcaa9 <br />Applican <br />Signature <br />7. Provisions of the LOUISVILLE MUNICIPAL CODE requiring the denial of the permit <br />application. Completion of this section by the Chief Building Inspector. <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 printed <br />application, specifications and plans, as well as any additional information <br />which would be helpful in the presentation of this case. <br />