none, Convert barn to ADU (approx 10, Application•
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APPLICATION FOR ADMINISTRATIVE APPROVAL
(Over the counter approval pursuant to Zone Clearance,
Chapter 17.44 of the Rolling Hills Zoning Ordinance)
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PROPERTY OWNER'S NAME
OWNER'S ADDRESS
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rNER'S TELEPHONE & EMAIL
PROPERTY ADDRESS
AGENT'S NAME
AGENT'S ADDRESS
AGENT'S TELEPHONE & EMAIL
NATURE OF PROPOSED PROJECT
Describe in detail the nature of the proposed project:
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Adm. Approval Rev.
Page 8 of 17 4/2016
Describe the proposedi?(s) of the project:
•
Pn'W.n' — 400?,_)
PROPERTY OWNER'S ACKNOWLEDGMENT,
I (We) declare that I (We) am (are) familiar with City's rules as they relate to this
project and with the submittal and construction requirements.
Incomplete applications will delay the approval process.
I (We) also understand that other than the City, prior to start of construction,
approval and building permits are required from the RHCA and Department of
Building and Safety and that any modification, change or variation to the approved
plans must be reviewed and approved by the agencies listed above prior to
commencing such construction.
I (We) declare Winder enalty of perjury that the foregoing application is true and
correct.
Date: � 2 1 �-" ) '61
By: � `�—
By:
Pro - • /. caner
Pr
arty owner
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Address
Date: %-2?726/7
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Adm. Approval Rev.
Page 9 of 17 4/2016
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