HomeMy WebLinkAbout2009-01-21; Planning Commission; ; LEGOLAND HOTEL CALIFORNIAThe City of Carlsbad Planning Department
A REPORT TO THE PLANNING COMMISSION
P.C. AGENDA OF: January 21, 2009
Item No. G)
Application complete date: NIA
Project Planner: Van Lynch
Project Engineer: Frank Jimeno
SUBJECT: SP 207(H)/LCPA 08-01 -LEGOLAND HOTEL CALIFORNIA -Request for
a recommendation of adoption of a Mitigated Negative Declaration and
Mitigation Monitoring and Reporting Program; a recommendation of approval for
a Specific Plan Amendment and a Local Coastal Program Amendment to add
hotel and accessory uses to Planning Area 4, Legoland, of the Carlsbad Ranch
Specific Plan, revise the parking rate for Legoland and gyms within the Carlsbad
Ranch Specific Plan, and change the street name from Hidden Valley Road to the
Crossings Drive on property generally located north of Palomar Airport Road,
south of Cannon Road, east of Paseo Del Norte and west of The Crossings Drive
in the Mello II Segment of the Local Coastal Program and in Local Facilities
Management Zone 13.
I. RECOMMENDATION
That the Planning Commission ADOPT Planning Commission Resolution No. 6524
RECOMMENDING ADOPTION of a Mitigated Negative Declaration and Mitigation
Monitoring and Reporting Program and ADOPT Planning Commission Resolutions No. 6525
and 6526, RECOMMENDING APPROVAL of Specific Plan Amendment 207(H) and Local
Coastal Program Amendment 08-01 based on the findings and subject to the conditions
contained therein.
II. INTRODUCTION
The project consists of a request to amend the Carlsbad Ranch Specific Plan to allow for hotel
and accessory uses within Planning Area 4, Legoland, to revise the parking rate for theme parks
and gyms, and to change the street name from Hidden Valley road to The Crossings Drive within
the Specific Plan. Legoland anticipates the development of a 250 room hotel within the parking
lot of the Lego land theme park. All necessary findings to approve this proposal can be made.
III. PROJECT DESCRIPTION AND BACKGROUND
The Lego land theme park is located within Planning Area 4 of the Carlsbad Ranch Specific Plan.
The Specific Plan regulates both the uses and development standards within the plan area. The
applicant is requesting approval of amendments to the Specific Plan which would: amend
Planning Area 4 to allow hotel and accessory uses to hotels, add design criteria for the hotel use,
modify the parking standards for the theme park and gyms within the Specific Plan, and reflect
the previous street name change of Hidden Valley Road to The Crossings Drive. The hotel site
is proposed to be located in the outer park area presently used as visitor, bus and RV parking.
SP 207(H)/LCPA 08-01 -LEGOLAND HOTEL CALIFORNIA
January 21, 2009
Pae 2
The inner park is defined as the passive and active attraction area and the outer park is defined as
the parking lot and landscape buffers.
The application also proposes to modify the parking rates for theme parks and gyms in the
Specific Plan. Carlsbad originally did not have a parking rate for theme parks and one was
proposed for Legoland based on other theme parks. Since Legoland has been in operation, the
parking demand has been better defined based on actual peak park parking needs. The proposed
reduction from 94.2 parking spaces per acre of active theme park to 80.08 is further discussed in
the analysis section of this report. The parking rate for gyms when the Specific Plan was
originally approved was 1 parking space per 35 square feet of floor area. Since the adoption of
the Specific Plan, the City processed a Zone Code Amendment (ZCA 03-03) to change the
parking rate to 1 space per 200 square feet of gross floor area. The amendment is to make the
Specific Plan consistent with the Zoning Ordinance.
The Specific Plan maps and text define the allowable type and intensity of land uses in each
planning area and provides detailed development and design standards, requirements,
development phasing and timing, and the method by which the Specific Plan will be
implemented. The proposed Specific Plan Amendment will add hotel and accessory hotel uses
to the allowed uses within Planning Area 4 of the Specific Plan as well as design guidelines for
the hotel.
Legoland anticipates the future addition of a 250 room hotel and accessory hotel uses for the
theme park. Accessory to the hotel would be retail sales, restaurant, staged entertainment, bar
and nightclub, outdoor pool and water play features. The hotel would be located southerly of the
pedestrian entry plaza. The hotel would incorporate Lego themed figures at the hotel entry,
pedestrian park entrance way and on the ends of the hotel. The hotel would also incorporate
architectural treatments using Lego themed materials. The hotel project will require the
subsequent processing of a Site Development Plan and Coastal Development Permit. The
proposed 45 foot tall hotel will require approval by City Council after a recommendation is made
by the Planning Commission pursuant to the requirements of the Specific Plan.
Access to the hotel will primarily be from the main park entrance. Guests staying at the hotel
will be directed to the hotel entry, then on to a separate 308 space parking lot which serves the
hotel. A gate controlled entry from The Crossings Drive will only allow entry of registered hotel
guests, charter bus service to the hotel, and North County Transit to access the bus stop. The
gate is located beyond the employee parking and service entrances so that employee and service
access is unimpeded.
The entire Lego land park area is roughly 128 acres in size. Planning Area Five of the Carlsbad
Ranch Specific Plan, which is currently vacant and designated as Open Space, is located adjacent
to the north, a resort/timeshare which is under construction is located to the east, and the
Legoland Drive main entrance with Planned Industrial uses beyond are located to the west.
The original Carlsbad Ranch Specific Plan was approved in 1993. The first amendment to the
Specific Plan was to allow the Legoland theme park in 1996. There have been two other
significant amendments for the development of the Museum of Making Music and the
development of Planning Area 5 for the hotel/timeshare project. Most recently, the Specific Plan
was amended to allow for the Legoland Inner park overnight stay program and modifications for
the widening and turn lane for Palomar Airport Road.
SP 207(H)/LCPA 08-01 -LEGOLAND HOTEL CALIFORNIA
January 21, 2009
Pa e 3
IV. ANALYSIS
The proposed project is subject to the following plans, ordinances and standards as analyzed
within the following section of this staff report:
A. General Plan Land Use Element -Travel Recreation/Commercial (TR) General
Plan Land Use Designation;
B. Tourist Commercial Zone -Qualified Development Overlay (C-T-Q) (Carlsbad
Municipal Code Chapter 21.29);
C. Carlsbad Ranch Specific Plan (SP 207(E);
D. Mello II Segment of the Local Coastal Program -Carlsbad Municipal Code,
Chapter 21.203, the Coastal Resource Protection Overlay Zone;
E. Comprehensive Land Use Plan for McClellan-Palomar Airport; and
F. Growth Management Ordinance (Local Facilities Management Plan Zone 13).
The recommendation for approval of this project was developed by analyzing the project's
consistency with the applicable regulations and policies. The project's compliance with each of
the above regulations is discussed in detail in the sections below.
A. General Plan
The General Plan Land Use designation for Planning Area 4 of the Carlsbad Ranch Specific Plan
area is Travel Recreation/Commercial (TR). The TR designation allows uses such as visitor
attractions and commercial uses that serve the travel and recreational needs of the tourist,
residents and employees of the business and industrial centers. Such uses may include hotels,
motels, restaurants, and recreation facilities and are intended to be located near major
transportation corridors or recreational and resort areas. The Carlsbad Ranch Specific Plan limits
the amount of development within the Legoland theme park. The proposed Specific Plan
Amendment proposes to add hotel and associated hotel uses as allowed uses within the Legoland
theme park. Hotel and accessory restaurant and retail uses to hotels are appropriate in the
location proposed as they will serve the Legoland theme park and are accessible from major
circulation element roadways (Cannon Road and Palomar Airport Road).
B. Tourist Commercial Zone -Qualified Development Overlay
The project is within the Carlsbad Ranch Specific Plan and all properties within the Legoland
Planning area are Zoned Tourist Commercial with the Qualified Development Overlay (CT-Q).
Development within the Specific Plan area is subject to the permitted uses and development
standards of the Specific Plan rather than the City's Zoning Ordinance. The Specific Plan maps
and text define the allowable type and intensity of land uses in each planning area and provides
detailed development and design standards, requirements, development phasing and timing, and
the method by which the Specific Plan will be implemented. The proposed Specific Plan
Amendment will add hotel and accessory hotel uses (restaurants, retail, staged entertainment, and
nightclub) to the allowed uses within Planning Area 4 of the Specific Plan as well as design
guidelines for the hotel. These uses are compatible with the existing tourist serving commercial
uses (Legoland theme park) within Planning Area 4 and are also uses that are permitted by the
Tourist Commercial zone.
SP 207(H)/LCPA 08-01 -LEGOLAND HOTEL CALIFORNIA
January 21, 2009
Pae 4
C. Specific Plan Amendment 207(H)
The applicant is requesting amendments to the Carlsbad Ranch Specific Plan to add hotel and
accessory hotel uses to Planning Area 4 and, more specifically, the Legoland Outer Park area.
The proposed list of accessory uses includes: Retail, Restaurants (not including drive-up or
drive-in services), Health and Fitness Clubs, Staged Entertainment, Recreational facilities for
water play, Rental car agency, Childcare facilities, Personal service (barbers, beauty shops, etc.),
Bars and Nightclubs, Art Galleries/Museums, and Administrative and Business Offices. The
Specific Plan text would also be modified to add specific development and design guidelines
which augment the general development standards for the hotel. The Specific Plan already states
that any development within the Outer Park requires the processing of a Site Development Plan.
As part of the hotel project, the applicant is requesting approval of an amendment to the Specific
Plan to allow limited access to the park (hotel) via The Crossings Drive and Palomar Airport
Road. The Specific Plan presently states that park guests will use Lego Drive via Cannon Road.
The project anticipates having all park guests, including new hotel guests, enter via Lego Drive.
Once a hotel guest is established, they would be provided optional access via The Crossings
Drive. The traffic study identified that the project will add 55 AM peak hour and 77 PM peak
hour visitor trips generated via The Crossings Drive to Palomar Airport Road. These additional
trips will distribute through the Palomar Airport Road and Paseo del Norte intersection, which
has been identified as impacted. Mitigation in the form of a new right turn lane from eastbound
Palomar Airport Road onto southbound Paseo Del Norte would increase the service level of the
intersection to an acceptable level. The dedication for the turn lane was previously secured with
the development of the Islands Restaurant project. The project has been conditioned to pay its
proportionate share of the turn lane improvements.
The project also includes a revised parking standard for the Legoland theme park. The original
project created a new parking generation rate as one did not previously exist within Title 21 for
theme parks. The original parking estimate for the park was 94.2 parking spaces per acre of
development. In 2007 the park had a peak vehicle attendance of 3,123 vehicles. Given the 39
acres of park development, the overall parking demand is therefore only 80.08 vehicles per acre
of park development (3, 123/39 = 80.08). With the addition of a hotel and accessory hotel uses,
the potential overall peak parking demand would be 4,168 parking spaces. The number of
parking spaces that would be available is 4,960 parking spaces. The remaining excess parking
spaces are overflow and may also be utilized during the build out of the theme park with future
uses in the expansion area.
In general, the Carlsbad Ranch Specific Plan contains a parking rate for gyms which is one space
per 35 square feet. In 2004, the City approved a citywide zone code amendment (ZCA 03-03) to
change the parking rate of gyms and health spas to one space
0
per 200 square feet of gross floor
area. The proposed amendment is to make the specific plan consistent with the Zoning
ordinance to include the 1/200 parking rate for gyms.
The Specific Plan Amendment also includes an update to change the project access street name
from Hidden Valley Road to the Crossings Drive to reflect the previously approved street name
change (SNC 07-01).
SP 207(H)/LCPA 08-01 -LEGOLAND HOTEL CALIFORNIA
January 21, 2009
Pa e 5
D. Mello II Segment of the Local Coastal Program
The project is consistent with the relevant policies of the Mello II Segment of the Local Coastal
Program and the Coastal Resource Protection Overlay Zone. The Specific Plan implements the
intent of the Travel/Recreation Commercial (TR) General Plan Land Use designation and TR
Local Coastal Program Land Use designation. With regard to consistency with the Local Coastal
Program, the Specific Plan is the implementing ordinance for the LCP. The LCP Amendment is
necessary to ensure consistency between the LCP and the Specific Plan. The proposed
amendment will not result in any conflict with the provisions of the LCP. The proposed
amendment is consistent with the Mello II Land Use Policies related to grading, landscaping,
erosion, steep slopes, landslides and slope instability, seismic hazards, erosion control practices,
or removal of native vegetation in that the site is a previously developed parking lot. The project
site does not provide or obstruct public views of the coast or provide coastal access as it is
located a mile from the coastline.
Additional Mello II Land Use Policies that are applicable to this site include Policy 1-1
Allowable Land Uses, Policy 2-2 Carlsbad Ranch Specific Plan "Mixed-Uses" Development,
Policy 6-5 Hotel-Motel rooms, Policy 7-10 Parking and Policy 8-5 Signage. The proposed
amendment is consistent with Policy 1-1, allowable land uses, since the proposed addition of a
hotel and hotel accessory uses are uses to be included within the specific list of allowed uses in
the Specific ~Ian and that the hotel is consistent with the General Plan and Carlsbad Ranch
Specific Plan as a Travel/Recreation Commercial Land Use. Policy 2-2 of the LCP provides
conditional development standards for the Specific Plan area to preserve and protect agricultural
uses. The proposed amendments would not affect agricultural uses as the proposed uses are
within the previously developed Legoland Outer Park. Policy 6-5 addresses the need for
additional hotel-motel rooms and visitor-serving commercial uses within the coastal zone. One
of the suggested locations is near I-5 and Palomar Airport Road and the proposed hotel use is
located near this intersection. The Legoland theme park is also adding retail and restaurant uses
which are visitor serving facilities. Policy 7-10 addresses parking standards set forth in the
Carlsbad Municipal Code. The parking generation rate for the theme park was established
within the Carlsbad Ranch Specific Plan. The project proposes and has submitted adequate
justification to reduce the generation rate from 94.2 to 80.08 parking spaces per acre of active
theme park use based on historic park visitor information. The c~ange to the gym parking rate
was previously approved by LCPA 03-10 and is being reflected in the Specific Plan. The
proposed amendments would not affect Policy 8-5, since no modifications are proposed to the
existing Sign Program.
A six-week LCPA public notice of availability period (October 10, 2008 to November 21, 2008)
was provided for the project. No comments were received.
E. Comprehensive Land Use Plan for McClellan-Palomar Airport
The project site is located approximately one mile westerly of the airport and is within the
Airport Influence Area for McClellan-Palomar Airport. The Airport Land Use Compatibility
Plan, McClellan-Palomar Airport (ALUCP) identifies that exterior noise levels up to 68 CNEL
would occur at the site. Exterior noise at this level is determined to be acceptable by the ALUCP
for the proposed hotel land use. The ALUCP indentifies that the interior noise levels would need
to be attenuated to 45 CNEL for the hotel use and 50 CNEL for the restaurant and retail uses.
SP 207(H)/LCPA 08-01 -LEGOLAND HOTEL CALIFORNIA
January 21, 2009
Pae 6
Mitigation measures have been conditioned for the proposed land use to require interior noise
level compliance prior to building permit issuance. Previous project approvals have required,
and the developer has recorded, a "Notice Concerning Aircraft Environmental Impacts." The
Carlsbad Ranch Specific Plan EIR identified that the Legoland entertainment use as a compatible
use with the airport.
F. Growth Management Ordinance
The proposed project is located within Local Facilities Management Zone 13. The proposed
Specific Plan Amendment modifications which anticipate a 250 unit hotel and accessory hotel
uses, parking standard changes, and access from The Crossings Drive (via Palomar Airport
Road) do not impact public facilities, with the exception of traffic impacts which have been
identified and mitigated through the funding of intersection improvements.
V. ENVIRONMENTAL REVIEW
Staff conducted an environmental impact assessment to determine if the project could have a
potentially significant effect on the environment pursuant to CEQA . Guidelines and the
Environmental Protection Ordinance (Title 19) of the Carlsbad Municipal Code. Potentially
significant cultural resources, geology, noise and traffic impacts were identified. The developer
has agreed to mitigation measures to reduce the identified impacts to below a level of
significance in accordance with CEQA. In consideration of the foregoing, the Planning Director
issued a Notice of Intent to Adopt a Mitigated Negative Declaration for the project on December
5, 2008 which was publicly noticed for 30 days.
ATTACHMENTS:
1. Planning Commission Resolution No. 6524 (SP 207(H) EIA)
2. Planning Commission Resolution No. 6525 (SP 207(H))
3. Planning Commission Resolution No. 6526 (LCPA 08-01)
4. Location Map
5. Background Data Sheet
6. Local Facilities Impact Assessment Form
7. Disclosure Statement
SITE MAP
• N
NOT TO SCALE
Legoland Hotel Carlsbad
SP 207(H) I LCPA 08-01 /
SDP 96-14(C) / CDP 96-16(C)
BACKGROUND DATA SHEET
CASE NO: SP 207(H)ILCPA 08-01/SDP 96-14(C)/CDP 96-16(C)
CASE NAME: LEGOLAND HOTEL CALIFORNIA
APPLICANT: Merlin Entertainment Group US Holdings
REQUEST AND LOCATION: A Specific Plan Amendment and a Local Coastal Program
Amendment to add hotel and accessory uses to Planning Area 4, Legoland, of the Carlsbad
Ranch Specific Plan and to revise the parking rate for Legoland and gyms within the Carlsbad
Ranch Specific Plan on property generally located north of Palomar Airport Road, south of
Cannon Road, east of Paseo Del Norte and west of The Crossings Drive in the Mello II Segment
of the Local Coastal Program and in Local Facilities Management Zone 13.
LEGAL DESCRIPTION: Lots 18 and 19 of Carlsbad Tract Map 94-09 Units 2 and 3, in the
City of Carlsbad, County of San Diego, State of California, according to map thereof no. 13408,
filed in the Office of the County Recorder of San Diego, April 1, 1997 as file number 1997
147754.
APN: 211-100-09 and 11 Acres: 128.32 Proposed No. of Lots/Units: -=--Nc....:/A'-=---------
GENERAL PLAN AND ZONING
Existing Land Use Designation: Travel/Recreation Commercial (T-R)
Proposed Land Use Designation: _S_am_e ___________________ _
Density Allowed: _N_/ A _______ Density Proposed: N_/ A __________ _
Existing Zone: Commercial Tourist-Qualified Overlay Zone (C-T-O)
Surrounding Zoning, General Plan and Land Use:
Zoning General Plan
Site C-T-Q T-R
North C-T-Q/O-S T-R/OS
South O-S OS
East Planned Industrial Planned Industrial
West O-Q/P-M-Q Office/Planned
Industrial
LOCAL COASTAL PROGRAM
Proposed Zone: Same
Current Land Use
Parking lot
Resort Hotel/Open
Space
Open Space
Golf Course
Office
Coastal Zone: C8J Yes D No Local Coastal Program Segment: _M_e_ll_o_I_I _____ _
Within Appeal Jurisdiction: D Yes C8J No Coastal Development Permit: C8J Yes D No
Local Coastal Program Amendment: C8J Yes D No (Implementing Ordinance)
Revised 01/06
Existing LCP Land Use Designation: T-R Proposed LCP Land Use Designation: Same
Existing LCP Zone: ~C--T~-.....,O.___ ___ _ Proposed LCP Zone: ~S~am~e _______ _
PUBLIC FACILITIES
School District: Carlsbad Water District: Carlsbad Sewer District: Carlsbad
Equivalent Dwelling Units (Sewer Capacity): =2=--50=--------------------
ENVIRONMENT AL IMPACT ASSESSMENT
D Categorical Exemption, ______________________ _
[8J Negative Declaration, issued _D_e_ce_m_b_e_r_5~2~0~08~--------------
D Certified Environmental Impact Report, dated ______________ _
D Other, ___________________________ _
Revised O I /06
CITY OF CARLSBAD
GROWTH MANAGEMENT PROGRAM
LOCAL FACILITIES IMPACTS ASSESSMENT FORM
(To be Submitted with Development Application)
PROJECT IDENTITY AND IMPACT ASSESSMENT:
FILE NAME AND NO: LEGOLAND HOTEL CALIFORNIA -SP 207(H)/LCPA 08-01/SDP
96-14(C)/CDP 96-16(C)
LOCAL FACILITY MANAGEMENT ZONE: .Ll. GENERAL PLAN: Travel/Recreation
Commercial
ZONING: Commercial Tourist -Qualified Overlay Zone
DEVELOPER'S NAME: Merlin Entertainment Group US Holdings
ADDRESS: 1 Legoland Drive, Carlsbad, CA 92008
PHONE NO.: (760) 918-5401 ASSESSOR'S PARCEL NO.: 213-100-09 and 11
QUANTITY OF LAND USE/DEVELOPMENT (AC., SQ. FT., DU): _17_1~,7_96_s__,q..__ft ___ _
ESTIMATED COMPLETION DATE: =-20"--'1'--"-0 _______________ _
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
K.
City Administrative Facilities: Demand in Square Footage= """N-'--"/A-=---------
Library: Demand in Square Footage = _N_/ A _____ _
Wastewater Treatment Capacity (Calculate with J. Sewer) 250 edu
Park:
Drainage:
Demand in Acreage =
Demand in CFS =
NIA
Identify Drainage Basin =
(Identify master plan facilities on site plan)
.7 cfs (net increase)
13B
Circulation:
Fire:
Open Space:
Schools:
Sewer:
Water:
Demand in ADT = 1 800 ~------
Served by Fire Station No. = _4 _____ _
Acreage Provided= 0 (No change)
NIA
Demands in EDU
Identify Sub Basin =
Demand in GPO =
250 EDU
Buena/Vallecitos
55 000
City of Carlsbad
14ihh,li,i·l•i4•Eihui4,il
DISCLOSURE STATEMENT
. Applicant's statement or disclosure of certain ow·nership interests on all applications which will require
discretionary action on the part of the City Council or any appointed Board, Commission or Committee.
The following information MUST be disclosed at the time of application submittal. Your project cannot be
reviewed until this information is completed. Please print.
1. 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 (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 ·-----------NA
Title ___________ _
Address _________ _
2. OWNER (Not the owner's agent}
Corp/Part Hofman P.lanni_n_g_ & Engineering
Title Applicant
Address 3 1 5 2 J _L_i_Qn.S h_~ a_d Ave
Carlsbad, CA 9201 0
Provide the COMPLETE. LEGAL names and addresses of ALL persons having any ownership,
interest in the property involved. Also, provide the nature of the legal ownership (i.e, partnership,
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 INDICATE
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 ___ N_A_· ______ _
Title ___________ _
Address ----------
D~rector -Andrew Carr
Corp/Part Merlin Entertainment Gro
Title US Holdings, INC (OWNER)
Address 1 Legoland Dr. -------------
Carlsbad, CA 92008
President -John Jakobsen
Secretary -Brian Shaw
1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (760) 602-4600 • FAX (760) 602•8559 • www.ci.carlsbad.ca.us @
3. NON-PROFIT ORGANJZA TION OR TRUST
Jf any person identified pursuant to (1) or (2) above is a nonprofit organization or a trust, list the
names and addresses of At£! person serving as an officer or director of the non-profit
organization or as trustee or beneficiary of the.
Non Profit/Trust NA Non Profit/Trust. ________ _
Title___________ Title. ____________ _
Address _________ _ Address ___________ _
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 twelve (12) months?
D Yes [g} No If yes, please indicate person{s): __________ _
NOTE: Attach additional sheets if necessary.
I certify that all the above information is true and correct to the best of my knowledge.
_/~~
~~_,,,,..__
_./
Signaturi__-
Brian Shaw
Print or type name of owner
~ Signature of applicant/date
Signature of owner/applicant's agent if applicable/date
Print or type name of owner/applicant's agent
H:ADMIN\COUNTER\DISCLOSURE STATEMENT 12/06 Page 2 of 2