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City of San Leandro 835 E. 14th Street San Leandro, CA 94577 Appeal Application To the City Council City Clerk City Clerk's Office 510/577-3366 Please provide the information required below and return this form with a check for S160*, (made payable to the City of San Leandro), to the City Clerk's Office at the address shown above. NOTE. Your application for an appeal must be made within fifteen (15) calendar days of the decision (ten days ifyou are appealing a Tentative Map approval). If the appeal period ends on a weekend or holiday, the time limit shall be extended to the next working day. Decisions of the Site Development Sub -Commission, the Planning Commission, and Board of Zoning Adjustments are appealed to the City Council. Please note that decisions of the Zoning Enforcement Official (ZEO) or the Development Services Director are appealed to the Board of Zoning Adjustment or the Planning Commission, depending on the specific project or issue. A Planning Commission/Board of Zoning Adjustments appeal form (light green) must be used for these applications. I wish to appeal the decision of the: ❑ Other ❑ Site Deve ment Sub -Commission; ❑ Planning Commission; W Board of Zoning Adjustments, for the ApprovaUDe (Circle One) in the matter of C-` <_� e `. 5'-, —_ (please indicate project name or Sle number, and protect address) which took action on ;rI�.., c of The grounds upon which this appeal is filed are: J-, st all grounds relied upon in making this appeal. Attach additional sheets if more space is needed) La �:; r1J GI fir o `f- Signature: 0/�1 L, �/ Name: �7) � t v� S "'' c> S /- d r v Y I (Please print) I am: ❑ the Applicant; ❑ Concerned Resident Other for the project in question. Mailin Address: c% ; J Daytime Phone Number: G *NOTE: If the appellant is the applicant, direct costs for processing the appeal, which may include but are not limited to preparation of staff reports and meeting attendance, are charged. .......................................................................................................................................................................................................................................................................................... CITY USE ONLY Date Appeal Received: Hearing scheduled before City Council on: By: (attach copy of receipt) To the Planner: Please submit the City Council Public Hearing Checklist and backup material to the City Clerk's Office not later than G. ICLERX1DEBBIDF0BVSiAPPEAL 01