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Home My WebLink AboutMCUP 09-03; SPRINT SD40XC316 PILGRIM CHURCH PCS FACILITY; Minor Conditional Use Permit (MCUP)• CITY OF CARLSBAD LAND USE REVIEW APPLICATION 1) APPLICATIONS APPLIED FOR: (CHECK BOXES) D Administrative Permit D Administrative Variance D Coastal Development Permit ~ Conditional Use Permit D Condominium Permit D Environmental Impact Assessment D General Plan Amendment 0 Habitat Management Plan Permit D Hillside D.evelopment Permit D Local Coastal Program Amendment D Master Plan . D Minor Conditional Use Permit 0 Non-Resldentlal Planned Development 2) 3) 4) ASSESSOR PARCEL NO(S}.: PROJECT NAME: (FOR DE?T. USE ONLY) □ ------1 □ 1-------1 □ □ 1--------1 □ 1--------1 □ -----□· 1------t □ □ t----------1 □ 1----- /\1CllP~- □ Planned Development Permit Planned·lndustrial Permit Planning Commission Determination Precise Development Plan Redevelopment Permit Site Development Plan Special Use Permit Specifjc Plan ,_, Tentatl\'e PaFOel Map Obtain from-Engineering Department Tentative Tract Map Variance Zone Ch~nge List other applications not s cified ~J)"i~ ~ (FOR DEPT, USE ONL 't} 5) OWNER NAME {Ptint or Type) Vi\ ir""\VY\. C\"\DTC 6) APPLICANT NAME.{Print or Type) ~,/fa-,ftJ /l,44.,C~ ,(/L_ MAILING ADDRESS /_pf)q I 'U->if' /tM./(w. IK!3iJP iJ1/J!()J • • TELEPHONE CITY AND STATE . ZIP TELEPHONE ~-700 1-zfl--6 ({j i~ftt?il /tf4/(X3 IP~s EMAIL ADDRESS: I CE:RTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE; INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. SIGNATURE DATE Form 14 • Rev. 03/08 EMAIL ADDRESS: PAGE1 OF4 • -·········-"····"· 7} BRIEF LEGAL DESCRIPTION 8) 9) LOCATION OF PROJECT: STREET ADDRESS ON THE I ~;,_; SIDEOF l m ?t;;:;:uu.__ I (NORTH, SOUTH, EAST; WEST) B~EEN I 671{ P]l/u)f-JI;@? I {NAME OF S1REET) · }> (NAMEPFSTREET) ._I ~~:....:.....<.=~....,,,,,,-:-==JJ-==)U.,11-,(-=·=---' (NAME OF STREEl) IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE NECESSARY FOR MEMBERS OF CITY STAFF, PLANNING COMMISSIONERS, DESIGN REVIEW BOARD MEMBERS OR CllY COUNCIL MEMBERS TO INSPECT AND ENTER THE P.ROPl;RTY THAT IS THE SUBJECT OF THIS APPLICATION. I/WE CONSENT TO ENTRY-FOR THIS PURPOSE. 10) NOTICE OF RESTRICTION: PROPERTY 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 U\ND AND BIND ANY SUCCESSORS IN'INTEREST. PROPERTY OWNER SIGNATURE FOR CITY USE ONLY· Form 14 • Rev. 03/08 . . . . ' R F • CITYO oRt RECEIVED FEB 2 6 2009 C~~R~ o;.__. , ~ Ykxfv---_ PAGE20F4- From: _ FEB~26-2~_9__ 11!U ~56 AH.RI.SBAD ENG !NEER !HG 03~2009 17:28 FAX NO, 760 aPio52 #024 P.002/005 1 D Mmi@lralt.ie P9ffll!l 0 Admlrllqtt,e V~nce D ~oer.~Pennlt ~ cond.lonaf Uae Permit 0 CondQffllnlum~Jt D Envln)rmel11al~~ 0 Genml Plan Amflndmenl1 D Hablal MarlllfllOlriPla(I P,nnlt 0 tfli&ida llit.•11110Pffl4111t P$ml!l □ Local Coesl.af Progl8ffiAmendmllnt □ MaaUlP'Plr. □ Miner Condlllonal u. Permit ,___ ___ ...... 0 Aennad ~Permit 0 PlaMedlndllatllalPermll )-----t D ---¢omlDl:iselc:in ~~ J Preol• Pellel®ment Plan □ RedOV$1opment Pennk 1-----1 0 SIiia Oe,,dopment P1tn • i----..... D Speda1 Use Peffllll t----t □ · SpedlJc Plan ~ ----□ kAd~·• PaliC Ma,-Obflliltwna.~ ClljJll!fflMt TtlfllatlVa ~ Mep Varienc:e 1.olw~ (RlltQePT', IIIICIIL'n 2) ASSESSORPARCEl.NO(S).: tlOo -~~,.. S) PROJECT>We pjL~~rnJLi+,;½ : : ·= 4} .9RIEFDESORFTIONOFPROJECT: -~~~~~~== ... ~~--¥-4~...,-=._--u=.,,..----= Farm 14. ~ O:WS . . . . ·;\ •' From: • __ FEB::?,~-209!JHU 08:55 AM CARLSBAD ENGINEERING 03,2009 17:29 FAX NO, 760 602 1052 #024 P.003/O05 P. 03 ,. ', . n eR1Er-U:a.u.oeSCR1PTION -re "1 ~P6 -t>ol( ,._... _____ ......;;,.__,_..c:.-_____________ _ 8) • L.OCATION OF PROJECT: iri&TAmAis§ 8) IN lHE Pf'oce88 0F REVIEWING THIS APPUCA110N rr MAY BE IIEC!SSARV FOR MIMBERS Of CITY SrAFF, Pl.ANNING ~S6IONERS. DESIGN Aa,IIEW BOAAO MeMBERS 0R a1Y CXlUNCII.. ME,MBERS TO INSP~CT Mm atTER P.R0PERTV 't'HAT iS THI! suaJECT OF 'MS APPUCAllON. WJE CONSENT TO ENTftY fOR THIS runr-u.ac. 10) RECEIVED \ · FEBO 9 2009· CITY OF CARLSBAD 0 !Va:> ...... Fonn 1.4 • Rcw.03108 . •·, ...... From: l J • FEt26~2009 THU 09:55 AM CARLSBAD ENGINEERING 3. NON~OF\T 0RGANIV-110N OR TRUST 03.2009 17:30 FAX NO. 760 602 1052 #024 P.004/005 P. 04 tf any peraon ldenllfted pursuant to (1) or (2) above la! nonprofit nmani2etlon or a trust. 119t 1M n&r11ea and addtell8ri of ANY person sarvlng u an officer or director of !he nan-profit organlutlon or as truatee or beneficiary of the, Non Proflt/Truaf 4x/A Non Profit/T,ust ~ TldL :::1/ft TltJe. • . ~ Addles$ WA Addrese,..__.:if...-~---- 4. Have you· had more 1han $500 worth of business nnsac;ted w«h any membar of City iatetr, aoardl. Commllslons, Committees and/or CounoU wtlhln Iha p.t: tweCve (~ months'? • . (Xly8$ [JNo. lfyes.pfaaaelndlcal8peraon(a);_¢~'ff ~~ NOTE: Atiach eddlllonal eheetl If necenal')'. G:.:s ~ J. li¥J.1Cil. Print or name of owner . • x Slgnatura of owner/appllcanfs egent If appllcablefdate K Print or~ n~s of own~ppHcant'e ~9e!lt . •. 2of2 I l • City of Carlsbad . · · 14Fihuht~--,a•tUii,O=ibi DISCLOSURE STATEMENT Applfcant's statement or disclosure. of certain ownership interests on all applications which will require discretionary action on the part of the City Council or any appointed Board, Commission or Committee. The followin·g information MUST be disclosed at the time of application submittal. Your project cannot be reviewecfuntil this information is completed. Please print. • 1. 2. APPLICANT (Not the applicant's agent) Provide the COMPLETE. LEGAL names and addresses of ALL persons having a financial interest in the application. If the applicant includes a corporation or partnership, include· the names, title, addresses of all individuals .owning more than 10% of the shares. IF NO INDIVIDUALS OWN MORE THAN 10% OF THE SHARES, PLEASE INDICATE NON- APPLICABLE (NIA) IN THE SPACE BELOW. If a publicly-owned corporation, include the names, ·titles, and addresses of the corporate officers. (A separate page may be attached if necessary.) Person tll#I---~a,,(__ Title;..._ ________ _ Address._· _______ _ OWNER (Not the owner's agent) Provide the COMPLETE, LEGAL names and addres~es of ALL persons having any ownership Interest In the property involved. Also, provide the nature of the legal ownership (i.e., partnersnip, tenants ·in common, non-profit, corporation, etc.). If the ownership includes a corporation or partnership. include the names, title, addresses of all individuals owning more than 10% of the shares. IF NO INDIVIDUALS OWN MORE THAN 10% OF THE SHARES, PLEASE INDfCATE NON-APPLICABLE (N/A) IN THE SPACE BELOW. If a publicly-owned corporation. include the names, titles, and addresses of the corporate officers. (A separate page may be attached if necessary.) • Person #?tt-f. dJi~-• Corp/Part 1/i(r(l;;c {!,,favS J. Title;...__________ Title. ___________ _ 1636 Faraday Avenue• Car_lsbad, CA 92008~731~ • (760) 602-4600 • FAX (760) 602-8559 • www.ci.carlsbad.ca_.us @_ 3. • • NON-PROFIT ORGANIZATION OR TRUST If any person identified pursuant to ( 1) or (2) above is a nonprofit orqanfzation or a trust. list the names and addresses of ANY person serving as an officer or director of the non-profit organization or as trustee or beneficiary of the. Non Profit/Trust" 0<.jt~ Non Profit/Trust,...._-~--'·;..;,,c,.;;M--=--____ _ Title Wf/' Title -t.~fa Address 0t,/A-Address. __ _,_'7(,-+f----'/J-____ _ .4. Have you· had more than $500 worth of business transacted with any member of City staff, Boards, Commissions, Committees and/or Council within the past twetve (1 ) months?· [ZJ Yes O No • If yes, please indicate person(s): ~~--'tfl,i,w NOTE:· Attach additional sheets if necessary. l certify that all the above information is true and correct to the best of_in.J knowledge. . -~ /R uv--r tJ es fiJ.S' s €7 ~ LL c {) X ~ &,i??l -~.:31ltfhJ? Signature of owner/date • y Signature o1' applicant/date Print or type name of owner Print or type name of)3J>pllcanf:.._ . _ J_ flll0trri<J:j e.~ ~K-eerJ_ eJf/-cv-g- Signature of owner/applicant's agent if applicable/date Print or type name of own~r/appllcant's agent 2of2 ... ·-• HAZARDOUS WASTE AND SU:~:iSTANCES STATEMENT Consultation Of~ists of Sites Related To Hazardous Wastes (Certification of Compliance with Government Code Section 65962.5) Pursuant to ~tate of California Go_vemment Code Section 65962.5, I have consulted the Hazardous Wastes and Substances Sites List compiled by the California Environmental Protection Agency and hereby certify that (check ·one): • ~ The development project and any alternatives proposed in this application are not contained on the lists compiled pursuant to Section 65962.5 of the State Government Code. • D The development project and any alternatives proposed in this appli_cation m contained on the lists compiled pursuant to Section 65962.5 of the State Government Code. Phone Number: ''7&0 --7'~9. hB// Addre~ofSit~: ~oa,D c/1..t,~ th!~tZ-(;a,t.£;/£2,-01t-~J - LocalAg~ncy(CityandCounty): t!l:$J ¢ ~/i1.{) 1 ~ -~t.R.J? ~ Assessor's book, page, and parcel number: tJ51fJ6 -~30 ~ ~ , , Specify list(s):. ____ ...,..... _____________________ _ Regulatory Identification Numh~r:,_ _________________ _,__ __ _ Date of List:. _______ ~-----,.------------,--------- Property Owner Signat~re/Date Admi11/C1111ntcr/HRzWas1c From: • FEB-26-2009 TH~ 09:56 A~ CARLSBAD ENGINEERIMG 03-2009 17: 30 FAX NO. 760 ar"1os2 . ,• . . HAZARDOUS WA.STE AND SmasTANCES STATIMBNT CaaraUaUouOfµss. ofSbela.al&nad To~ Wata {OdiflcalicmofCoinpllall,o6wlih~CodoBocdoA 65962.S) . . . Pwsuant 10 ~ ofCaUfbmla OonmQUW Code Socdoa 6.5962.S, I brvo oonsullod the~ WUl&'f 11114SubetaoDN Slt•l.istcomp'led byd»CtlUbmf■ Eavh=mUlflll~Aaeney IUld tsamyoerdt/ t1lat (c:=k"om,): • . tJ Thedo1iWl.-,m projectand .v 11ttm• ptOJ)Olled bl 1ld8 appllcatloil UUtl~Dd oa lbe. UIIBcampJJcd. ~ Cc 8eodtm 65962.S ofibo Slate Oovimimm Codo. 0 'IbD d6't~Clllt piqlcatand 1111 IHlmldfvet pS0pmcd in thla •P~ ,iscoatamedcn tile Utt& ca41piled pamuint 1o ~ 65962.5 oft!= S18to Gvm.uMAi Code. • • • APMJCANT • • • · P.R.O~Tf (;}WNER. ~-~ ¢1:S, aw.l:.ML'&alc, '-f~-~ Acfk'il /,f}q/ ~ f'M,{~ . Alknu: fl.(JAO ~ M~ Od!-'i~ia /14(. /SS ~SL e ~bl), e'4 ~ Pllanol(vmber. l/(t)•SfJ.'Z"'7,(e'fi PholloNamllar; •"ft,{) -'7'8f, It,'!)// . ' . ~or~ {&OaD ~ (/41~ (;~, tblt-~~ Laoll~ (Cl~ ••~one,~ .('Jf.g ¢ f!tdki4J 1 ~ j)a/(J ~ ~slloolr.pap.atdJNVCOl,aumbrir. ;,91)6 ~~ "{xk • Spec(t,1111(1),._• -------~----------- Ro&ulaux)' ldllltif1C81.km N~--------------- DNsafl.lA:. __________ ........,""--_-_..,..____.,. __ -::, tlu~ ... x~ _,,~,_ . ...-, A~1lt Sigi1ltll~t& ~-•. J •••• •• • .... . . · #024 P.005/005 P, 05 .... • • City of Carlsbad 1635 Faraday Avenue Carlsbad CA 92008 111111111111111111111111111111111111111111111111111111111111111 Applicant: SPRINT PCS ASSETS LLC Description MCUP0903 2020 CHESTNUT AV CBAD Receipt Number: R0073805 Transaction Date: 02/26/2009 Pay Type Method Description Payment Check Amount 800.32 Transaction ID: R0073805 Amount 800.32 Transaction Amount: 800.32 ct ~LON 01'--s:t-o .. 0)0'} 00 O)C) ti .s~g; CO L. CO 0 ..Cl'--Cl.lNN en w-~--..... r-+-'..C:N ~ s.....cooor:o CO (!) CO N C..) C..) C..) ~ 4->, >,,.!...{a 0 CO COO LL. ti ti I'->. CO co LO~ +-'L.L.C):::, ·~ co co 0) .c C..) LL LL O f-- r--co c::, C) -- ' ~ c::, ,..... LO ::::) en 0 a::. .. L .0 = 4-Q) a::: +-' a. Cl) Cl Q) a::: c::, ;-.. c:, c:, :::c:: LLJ I--..... :::.:, t"-1 N C r.J (r") I.._ :Y') C:,. moo co-co ---- .Y.:..!-<:~ U Cl <O Q.l Cl) +-' ...c:.c 0 u u f-- _., <O -0 Q.) u C ro (1) > <O :r:: SPRINT NEXTEL Sprint P.O. Box 63670 DATE 02/17/2009 VENDOR NAME CITY OF CARLSBAD CA Please detach and retain this statement as your record of payment. --10886045 VENDOR NO. 0000206072 0.00 697.00 JSHAP2bX-0001S4-01-37 ~ --;;;;;;;;;;;;; = ~ --- ;;;;:;;;:;;;; = SPRINT NEXTEL Sprint . . P.O. Box 63670 DATE 02/05/2009 VENDOR NAME CITY OF CARLSBAD CA Please detach and retain this statement as your record of payment. i. 10876464 VENDOR NO. 0000206072 0.00 103.32 --= -;;;;;;;;;;;;; ;;;;;;;;;;;;; --- ---;;;;;;;;;;;;; -----------