ltr Diane Chandler encl application package 9624

TOWNSHIP OF WEST ORANGE APPLICATION FORM FOR THE 1S ANID ENGR SL OyV UDO) AGNI IN( CM SLO)-VUD RO) o-VDIIOKWRVISINEE A. APPLICANT INFORMATION Full Legal Name: Zinnta. Health LLC (Last) Mailing Address: 530 Vewlport Certer wy, wessO 0, Newport Beach, CH 426 YP (Street) (City) State) _ (Zip) Telephone Number: (6%) 251-4020 Email: ‘he ka —_ 4 mail, COM Is the Applicant an: 1 Individual, §¢ Corporation, O) Partnership, 0 Other Uf the Applicant is a corporation or partnership, a list of the names and addresses of persons having a 10% interest or more in the corporation or partnership must be attached. Relationship of the applicant to the property: (1 Owner, % Tenant or Lessee, (1 Purchaser under contract (with consent of owner, (1) Other (please specify) If the applicant is not the owner of the property in question, the applicant must submit an affidavit with the owner(s) authorization to proceed with this process. B. PROPERTY OWNER INFORMATION CL] Check here if same as applicant. If the owner is not the applicant, please complete the following: Owner's Name: LS SP Cantecby ry, LLC j7 Address: 3 | Mallard Drw ey Llougd Harbor, Nu 74 3 Telephone Number: SIlg 579- (lO7T Email: Sc Ott @ lbutman fe. COM C. PROPERTY INFORMATION Street Address: 33 Ur, Peasant ANvenu eC. Block Number(s): S97 ; Lot Number(s): D-(y ; Tax Plate: ; Zone of Property: O R -> The location of the property is approximately Hr )O_ feet from the intersection of i 1, (e [asa at SN CA 2 and (No Wal Street (closest intersection.) Has there been any previous Zoning Board of Adjustment or Planning Board hearings involving this property? Cl Yes, Date(s): >MNo If yes, please attach copies of the written decisions adopted by the Board to each application. Please attach a list of all contiguous or adjacent property owned by the applicant or owner. +2 None [s this property listed in “The Historic Sites Survey” prepared by Robert Guter 7/9/1992. ©] Yes ye No TAPLANNING.BRD Document Librury\PB-ZBA Application $-20-15. doc