Loading...
HomeMy WebLinkAboutCD 2017-0005; CORBIN HOUSE; Administrative Permits (ADMIN),„,•-^t, 'sm."'god LINGIr" CITY OF CARLSBAD APPLICATION FORM FOR CONSISTENCY DETERMINATION APPLIC TION CITY USE ONLY Original Project Number:p 1 .0....Consistency Determination Number:CA)Stsi 1 -*00©5-, PROJECT NAME:1'It Assessor's Parcel Number(s): Description of proposal (add attachment if necessary):OA Yes '...NoWould you like to orally present your proposal to your assigned staff planner/engineer?0 Please list the staff members you have previously s oken__to regarding this project.If none, please so state. GT03 Rs‘wir rafft % Vali Wei previously s NAME (Print):att CI 1 fl APPLICANT NAME (Print), i • 111:110,a-ess 101 MAILING ADDRESS:g MAILING ADDRESS:22.2 ilyibriroSe.re . CITY, STATE, ZIP:M i sia. eti cta083 CITY, STATE, ZIP:\IC pk InTELEPHONE: ra_qatig leigLaaana.TELEPHONE:760 10(111' •SO 39. EMAIL ADDRESS:y\my. or bi(torkirrom EMAIL ADDRESS:NWACorcrt &Lyda/X:01 *Owner's signature indicates permission to condSit a preliminary review for a development proposal. IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE NECESSARY FOR MEMBERS OF CITY STAFF TO INSPECT AND OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE ENTER THE PROPERTY THAT IS THE SUBJECT OF THIS AND CORRECT TO THE BEST OF MY KNOWLEDGE. APPLICATION.I/WE CONSENT TO ENTRY FOR THIS PURPOSE.I CERTIFY THAT I AM TH EGAL OWNER AND THAT ALL THE ABOVE INFO'MAC •N IS T U ND CORRECT TO THE BEST OF MY /7 Kr/ L;ir GE.///1 /1.1 N .TURE D E SIGNATURE ATE APPLICANT'S REPRESENTATIVE (Print): MAILING ADDRESS: CITY, STATE, ZIP:RECrivEDTELEPHONE: EMAIL ADDRESS:MAR 2 4 2017 cl rY ()L Lr:AR.io„hpICERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE APP,I.JCANI/w 1 r-pu -ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE..„....;7\...,,.)!V!S 'ON SIGNATURE DATE FEE REQUIRED/DATE FEE PAID:41 -- .7 .55 oc.3 i •2..I RECEIVED BY:OlitiVaJt iekic-trn.. P-16 Page 2 of 2 Revised 08/16