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Exhibit CC 7-15-14 Item#3 Withdrawn Claim
CC 7-15-14 Item#13 FCUPE�R(TINO L City of Cupertino x0300 Torre Avenue JUN 2 3 2014.Cupertino, ACA 95014 C U P S R.T 1 N O (408) 77'7•,3223 CITYe«FRK APPEAL 1. Application No.: U-- 201V--01)* AS-`— 20 r ~o J 2. Applicant(s) Name: - 3. Appellant(s) Name: Address. Ica /V,.©GZ- C4141 Phone Number: t / Email: cap -Tj C2, Aw 4. Please check one: ,Appeal of Administrative Decision ,�-- Appeal a decision of Planning!Conunission Appeal a decision of Design Review Committee Appeal a decision regarding a'Tentative Map Appeal a decision regarding Street Improvements Appeal a decision of Code Enforcement-Massage 5. Date of determination of Director or mailing of notice of City decision: 6. Basis of appeal(attach additional sheet if necessary): I?-` �► , PPA Signature(s) Please complete.form.,include appeal.fee of$1-77.00 pursuant to Resolution No. 13-030 ($166.00 for massage application appeals), and return to the attention of the City Clerk, 10300 Torre Avenue,Cupertino, (408) 777-3223 GACity ClerklAppeals\A.ppeal forzn.doc