HomeMy WebLinkAboutLCPA 01-15A; NPDES STORMWATER UPDATE; Local Coastal Program Amendment (LCPA)CITY OF CARLSBAD -
LAND USE REVIEW APPLICATIO~
1) APPLICATIONS APPLIED FOR: (CHECK BOXES)
{FOR DEPARTMENT (FOR DEPARTMENT
USE ONLY) USE ONLY) □ Administrative Permit -2nd □ Planned Industrial Permit -
Dwelling Unit
□ Administrative Variance □ Planning Commission
Determination
□ Coastal Development Permit □ Precise Development Plan
□ Conditional Use Permit □ Redevelopment Permit
□ Condominium Permit □ Site Development Plan
□ Environmental Impact □ Special Use Permit
~ Assessment
General Plan Amendment GPf\ o l-\5 □ Specific Plan
□ Hillside Development Permit □ =FeA'l:a'l:i>o<e PaFeel Ma13
\~ Local Coastal Plan Amendment
. Obtain from Engineering Department
LcP ~ O l-15 □ Tentative Tract Map
D Master Plan □ Variance
□ Non-Residential Planned □ Zone Change
Development ~ □ Planned Development Permit List other applications not ZCA Ol-08' soecified
ASSESSOR PARCEL NO(S).:
PROJECT NAME:
BRIEF DESCRIPTION OF PROJECT: Rev,'5ion5 +o Gr. P. j Cod~ {a r re~,.,ed tJ Poe 5
5) OWNER NAME (Print or Type)
MAILING ADDRESS
CITY AND STATE ZIP
u. • ().~~
6) APPLICANT NAME (Print or Type)
C ,· t O .f Corl~ bad
MAILING ADDRESS
l63S Fara.do
~ 7✓0-
A-v 6 OJ_ ... <·-/600
TELEPHONE CITY AND STATE ZIP TELEPHONE
Co r (s) 6 a J C tA-9J 00 ~
I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE
INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND
KNOWLEDGE. ORRECT TO THE EST F MY KNOWLEDGE.
SIGNATURE DATE SIGNATURE DATE
7) BRIEF LEGAL DESCRIPTION
_ lX-vDttCO
NOTE: A PROPOSED PROJECT REQUIRING MULTIPLE APPLICATIONS BE FILED, MUST BE SUBMITTED PRIOR TO 3:30 P.M.
A PROPOSED PROJECT REQUIRING ONLY ONE APPLICATION BE FILED, MUST BE SUBMITTED PRIOR TO 4:00 P.M.
Form 16 PAGE 1 OF 2