HomeMy WebLinkAboutCD 2019-0012; ABDI RESIDENCE; Consistency Determination (CD)CITY OF CARLSBAD APPLICATION FORM FOR CONSISTENCY DETERMINATION APPLICATION
CITY USE ONLY Development Number: € ISO$?
Original Project Number: cDf 1$-"-I $ Consistency DetermJna~ti~·o"""'n-=N~u--m-:b~e--r-: c~9!f_\.,,.4\--""'d_O.,..,,l .----
PROJECT NAME: Jll:E. A.r,p1 g,= $\P'eNC#,
A~essor's Parcel Number(s): ----=2=-l""O'-•-Of,a::;..,EJ..l --t ,!,,iiL--_,c,o_'-------------------
D~crfption of proposal (add attachment If necessary):
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Would you like to orally present your proposal to your assigned staff planner/engineer? Yes 0 □
No
Piease 11st the staff members you have previously spoken to regarding this project. If none, please so state.
OWNER NAME (Print):
MAILING ADDRESS:
CITY, STATE, ZIP:
TELEPHONE:
EMAIL ADDRESS:
Behrooz and Sharon Abdi
18485 Wjthey Road
Monte Sereno CA 95030
858-245-9395
blabdi@yahoo.con\
"Owner's signature Indicates permission to conduct a preliminary
review for a development proposal.
IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE
NECESSARY FOR MEMBERS OF CITY STAFF TO INSPECT AND
ENTER THE PROPERTY THAT IS THE SUBJECT OF THIS
APPLICATION. INVE CONSENT TO ENTRY FOR THIS PURPOSE. I
OERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE
r INFORMATION IS T UE AND CORRECT TO THE BEST OF MY
KNOWlEDGE .•
. 5/16/19
SIGNATURE -OA_T __ E ___ ·•
APPLICANT'S REP"RESENTATIVE (PFlnt):
MAILING ADDRESS:
CllY, STA1E, ZIP:
APPLICANT NAME (Print): g I C.tW/) \4,AlJ F""':::'W
MAILINGADDRESS: U-z1 E-U).t.J04Lf-4.C!)IUl\'f .. f~
CITY, STATE, ZIP: i;tztP.,mN;iJl64-S 7]t>71
TELEPHONE: • 7b0. s,, ·Tl1+ .
EMAIL ADDRESS: .. r lg((:? +kc.c,rrc:.hije Lil. {D"'i
I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE
OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE
AND CORRECT TO THE BEST OF MY KNOWLEDGE.
DATE
TELEPHONE: 140. s,, . ,174
EMAIL ADDRESS:
. ' I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE APPLICANT AND THAT ALL THE ABOVE INFORMATION IS TRUE AND
ORRl:CT TO THE B T OF MY KNOWLEDGE.
~-12 .l'J ATE
FEE REQUIRED/DATE FEE PAID:
RECEIVED BY:
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· ., Revised 07/17