SR-402-004 (10)
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City of
Santa Monica
Department of Planning and Community Development
Planning and Zoning Division
(310) 458-8341
APPEAL FORM
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Date Filed
Received By
Receipt No.
Name Su (rr &J~J1}LS t-L-C
Address '?9 (L-( P, R tJ A- 0 W ('4-. 'I
Contact Person v~,.v4-T"1rt-v'l ft,5RJ1J G Phone <' 3(5 -rY!'J~r5
Pleas~scrioo 1ht project anCdeC]Sionto be appeal eo ..6 L '1109cr--lf~~j" .
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Case Number G ~ P . q~ - ~ ~=5
Address 79 =1 B ~ A-- 'I
Applicant -:'5 u l Tl!:=" eLJ LvvlS L. L.-C
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Please provide two self-ad ressed, stamped, letter-sized envelopes.
Signature
Date
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