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HomeMy WebLinkAboutEIA 2018-0006; PARK DRIVE DRAINAGE AND STREET IMPROVEMENTS; Environmental Impact Assessment (EIA)( City of Carlsbad LAND USE REVIEW APPLICATION P-1 Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.gov APPLICATIONS APPLIED FOR: (CHECK BOXES) Development Permits D Coastal Development Permit D Minor D Conditional Use Permit D Minor D Extension D Day Care (Large) ~ Environmental Impact Assessment D Habitat Management Permit D Minor D Hillside Development Permit D Minor D Nonconforming Construction Permit D Planned Development Permit D Minor D Residential D Non-Residential D Planning Commission Determination D Reasonable Accommodation D Site Development Plan D Special Use Permit D Minor D Tentative Parcel Map (Minor Subdivision) □ □ Tentative Tract Map (Major Subdivision) Variance D Minor (FOR DEPT. USE ONLY) Legislative Permits €JA ltiiif,OOJ D General Plan Amendment D Local Coastal Program Amendment D Master Plan D Specific Plan D Zone Change D Amendment D Amendment D Zone Code Amendment South Carlsbad Coastal Review Area Permits D Review Permit D Administrative D Minor D Major Village Review Area Permits D Review Permit D Administrative D Minor D Major (FOR DEPT. USE ONLY) E NOTE: A PROPOSED PROJECT REQUIRING APPLICATION SUBMITTAL MUST BE SUBMITTEO BY APPOINTMENT'. PLEASE CONTACT THE APPOINTMENT SPECIALIST AT (760) 602-2723 TO SCHEDULE AN APPOINTMENT. ASSESSOR PARCEL NO(S): LOCATION OF PROJECT: NAME OF PROJECT: BRIEF DESCRIPTION OF PROJECT: IIVSTA:t-l PROJECT VALUE (SITE IMPROVEMENTS) FOR CITY USE ONLY •SAME OAY APPOINTMENTS ARE NOT AVAILABLE :2.07-/Od -5 70,Q I 'i 7 Q 7 A-P-t::. DR.I\/£ Di2-I !I€ (STREET ADDRESS) • DRA 1,.J,A. <O~ • S Tfl._EcT ESTIMATED COMPLETION DATE Development No. ~ V l':J 1,A)\ '(-OOOf Lead Case No. P-1 Page 1 of6 Revised 03117 OWNER NAME (PLEASE PRINT) APPLICANT NAME (PLEASE PRINT) INDIVIDUAL NAME INDIVIDUAL NAME i'Af.t u/2.Ew (1f applicable): ~ (if applicable): COMPANY NAME COMPANY NAME (if applicable): (',,!¥ ,,p-~II~.£) {if applicable): {'_ ( 1Y of" <'.'Al<.L.'.SB/\..o MAILING ADDRESS: (1,135" t='MAD,1'1 AVE=:· MAILING ADDRESS: Jii2 '3~,(!A.Q.LS8AO, ~ 9'2~0S- CITY, STATE, ZIP: MeLS&<ID, CA 9 z. =fi" CllY, STATE, ZIP: f:Al><'-&4--1 ,Ai/&· > TELEPHONE: 1L-t2.-"""z. -'-\t.,44 TELEPHONE: 7~c-/,,,o'Z.r ~1,':JY EMAIL ADDRESS: EMAIL ADDRESS: ::pom, d.r: ... i & &rls!..Jea ., I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE OWNER INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY AND THAT ALL THE ABOVE INFORMATION tS TRUE AND CORRECT TO KNOWLEDGE. I CERTIFY AS LEGAL OWNER THAT THE APPLICANT AS THE BEST OF MY KNOWLEDGE. SET FORTH HEREIN IS MY AUTHORIZED REPRESENTATIVE FOR PURPOSES OF THIS APPLICATION. ~,.-=:;>_,p2 .'?-U,-t a-SIGNATURE DATE SIGNATURE DATE APPLICANT'S REPRESENTATIVE (Print): MAILING ADDRESS: CllY, STATE, ZIP: / TELEPHONE: / EMAIL ADDRESS: / I CERTIFY THAT I AM THE REPRESENTATIVE OF THE APPLICANT FOR PURPOSES OF THIS APPLICATION AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. SIGNATURE DATE IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE NECESSARY FOR MEMBERS OF CITY STAFF, PLANNING COMMISSIONERS OR CllY COUNCIL MEMBERS TO INSPECT AND ENTER THE PROPERTY THAT IS THE SUBJECT OF THIS APPLICATION. I1\AJE CONSENT TO ENTRY FOR THIS PURPOSE. NOTICE OF RESTRICTION: PROPERlY OWNER ACKNOWLEDGES AND CONSENTS TO A NOTICE OF RESTRICTION BEING RECORDED ON THE TITLE TO HIS PROPERTY IF CONDITIONED FOR THE APPLICANT. NOTICE OF RESTRICTIONS RUN WITH THE LAND AND BIND ANY SUCCESSORS IN INTEREST. PROPERTY OWNER SIGNATURE FOR CITY USE ONLY DATE STAMP APPLICATION RECEIVED RECEIVED BY: I /lee!rdl!.. P-1 Page 2 of 6 Revised 03117