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Home My WebLink AboutCT 02-17; Shelley Property; Tentative Map (CT) (2);C.,-~. \., CITY OF CARLSBAD • LJD USE REVIEW APPLICATION r-· 1) APPLICATIONS APPLIED FOR: (CHECK BOXES) (FOR DEPARTMENT (FOR DEPARTMENT USE ONLY) USE ONLY) 0 Administrative Permit -2nd D Planned Industrial Permit Dwelling Unit 0 Administrative Variance D Planning Commission Determination D Coastal Development Permit D Precise Development Plan D Conditional Use Permit D Redevelopment Permit 0 Condominium Permit D Site Development Plan ~ Environmental Impact D Special Use Permit Assessment 0 General Plan Amendment D Specific Plan [Z1 Hillside Development Permit HDP o~-o~ D +eAtative Pefeel Me~ Obtain from Engineering Department 0 Local Coastal Plan Amendment [lJ Tentative Tract Map Cl ~-~7 0 Master Plan D Variance 0 Non-Residential Planned D Zone Change Development fZJ Planned Development Permit PVt:> o~ ·df D List other applications not specified 2) ASSESSOR PARCEL NO(S).: ----!2::::...=1.....::~_-_0_~_:_{_-_tD_I '---O_'Z.-____________ _ 3) PROJECT NAME: _S~-H.:..::f=-L_L.....::.E_Y.:__....:...P__:a.._o..:....fl.!::::e=rz::..:..:r-!.-r ______ ---:,------ 4) BRIEF DESCRIPTION OF PROJECT: 4-q (.2-l S"lf.lliL--E t=A-64illl..'t' LoTs jutJ t-'TS" 6) OWNER NAME (Print or Type) 'DA).)\.~l---r. ~ h+E-t..L£ 'r' MAILING ADDRESS P. t>. (;o)( 'Z ~ o 4g'S' .CITY AND STATE ~tJCI ~rtlrS J C~. t "2. Of'ritv SPA:~ \.ott o ,u 8(, ~ ¢c~C"S 6) APPLICANT NAME (Print or Type) L-A"I>'-' . .H4 IOESt 4 IV (;,(LD ufJ, I ~ c ?-o~tt-\ c. L-At> Wt G MAILING ADDRESS lOS P""-{....0114Ptfl-A-1 i.PDILI 'Rb .# ?t:>a TELEPHONE CITY AND STATE ZIP ftf,15tt-t.2/IY CAaL-S~ , cA.o,wocr TELEPHONE £'o 4-~B-~tS I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY 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. KNO • DATE 7-Z2-~ ~~ SIGNATURE 7 I u:-1 I) z.._ DATE 7) BRIEF LEGAL DESCRIPT ?D~. e ~t--LD\ l"--2.t1o l..~S' ~k.)C.t~.j11'tS' -P~k-;1/TP 84~ -(-'lt..E.O fs,/1.1/lfqtf '· NOTE: A PROPOSED PRO.JECT REQUIRING MULTIPLE APPLICATIONS BE FILED, MUST BE SUBMITTED PRIOR TO 3:30P.M. A PROPOSED PROJECT F:EQUIRJNG ONLY ONE APPLJCATION BE FILED, MUST BE SUBMITTED PRIOR TO 4:00P.M. Form 16 PAGE 1 OF 2 L--lOOS'" • • " 8) LOCATION OF PROJECT: STREET ADDRESS ON THE SIDE OF I r2.Ak)c.'*o ~~1)11. F'IC ~ Bf'f\IVEEN (NORTH, SOUTH, EAST, WEST) I ,41> J J\CP:.kY\" 1-u f pCtl!-cf.a'41D (NAME OF STREET) (NAME OF STREET) (NAME OF STREET) 9) LOCAL FACILITIES MANAGEMENT ZONE \\ '----------' 10) PROPOSED NUMBER OF LOTS a,,) NUMBER OF EXISTING 012) PROPOSED NUMBER OF RESIDENTIAL UNITS RESIDENTIAL UNITS 13) TYPE OF SUBDIVISION ,¥?, .. \ 114) PROPOSED JND OFFICE/ B 1 5) PROPOSED COMM SQUARE FOOTAGE SQUARE FOOTAGE 16) PERCENTAGE OF PROPOSED /iPSlul17l PROPOSED INCREASE IN j4£lo 11 8) PROPOSED SEWER PROJECT IN OPEN SPACE ADT USAGE IN EDU 19) GROSS SITE ACREAGE 1~\ ~\120) EXISTING GENERAL ~21) PROPOSED GENERAL PLAN s PLAN DESIGNATION 22) EXISTING ZONING ~23) PROPOSED ZONING ~ 00 0 ~ EJ [ill ~ s 24) IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE NECESSARY FOR MEMBERS OF CITY STAFF, PLANNING COMMISSIONERS, DESIGN REVIEW BOARD MEMBERS OR CITY COUNCIL MEMBERS TO INSPECT AND ENTER THE PROPERTY THAT IS THE SUBJECT OF THIS APPLICATiqN. 1/WE CONSENT TO OR THIS PURI'O ( lU l"Tlf 2.4-~ov(L N D(k.,.: PL..rA..S£) FOR CITY USE ONLY FEE COMPUTATION . APPLICATION TYPE cr Od.-~I HDP Cd.-D'& FUD C>d,.-C>4 E1:A TOTAL FEE REO.UIRED DATE FEE PAID Form 16 FEE REQUIRED LD)~~. ~ a-~7 .~~ .S.c;;;C>t> \ L~ AUG 0 7 2002 CITY OF CARLSBAD PLANNING DEPT DATE STAMP APPLICATION RECEIVED RECEIVED BY: RECEIPT NO. PAGE 2 OF 2 FROM .08/17/2'00!1 11':04 FAI '1604380- FAX NO. :8587562051 DEXTER WILSON ENG • ug. 17 2005 11:21AM P1 ~00'% ~-CitY of Carlsbad ------------~~--~=-~l'~"am"IJI.~ia.~,~·z,t!~iiiD·maaaiiaszaJ~I~'m'~'itiAc·~'Ci' DISCLOSURE STATEMENT App1ir;ant's statement or disclosure of certain ov.nership intl!teStS on all applications which wilt n~qum.~ discretionary aetian on the 1'&rt ofmt City Council or any appoirlted Board.. Commission or c~~mttnnee. The followins information MUST be disclosed at th" tilnc Qf application submi~l. YoYr rro.1ect cannot be reviewed tmtil this information is completed. Please ])riBt. Nutt; Parson is ddiAed as '"A!ly illdividual, 1lrm, ct>-pat!nersbip, joint vmt~Ue, li!isodation, social club. fnltrmal crganiza'lion. CGrporatiOD, 8$Utt. INSit =ever, S)'l1CIJcate, iD Ibis llld my other ~ouuty, city 11nd county, eitr nn&ali~. 4isu1a or otlmr poBtkal sutlliivi&ion or any other JI"OUP or combilwioD KNll aa a uuit." ActDts may sip tbi& doc~~m~nt; ))owever, the legal DmJe aDd entity r1f' the a:ppllC~Lt~t .nc:t pr~etty own~r mU5t be provided below. 1. APPUCAI\'T (Not the applicianfs aacnt) Provid~ the COMPLETE. LEGA.L names an4 addresset. of .Al.J.r. persons having a f.IIlartcial interest in the application. If d\c applicant includ~s a egrporation or patln;rship, include the names, title, addresus of all indivi.dusls owning more than 10% of the shares. IF NO ll\'OJVmUA.LS OWN MORE THAN 10% OF THE SRA!tES. PLEASE INDICATE NON-. APPUCABtE (NfA) Th: THE SPACE BtLOW lf a publiclv-own~ emporatimh include the names. titles, and addresses of the: ~orporate officers. {A separate page may be anached i ( nece.ssJU)'.) , · ,/ Person ensl'\g'2~·)(9A\,'t\\"' '\)~\h)lt~r Corp/Part tAJ.R.. ~!11!.) Yl.ft-C..E r, (.(.(.. ./ Tttle Hiu»~!?J:Q,\r~kc,\l(l,\~,lJ&"Title App!ti;akli -0 Wkj er v Addresst; (!) i!>o¥ '1..'0%1>~ Address /?.IJ. &rt ~ 1tJIP W . ~Y\C\'t\\-\a.'.;>, C.A ~C'l.02-'3 {L~IJ.Jirlt$1 a,4. 'J2.-'L1·t:J~1rf 2. oWNER (Not the ownc=r'i asent) . Provide the COMPLij'[E. LEGAL umes and addrcssei of~ persons having any ownership interest w the property mvolved. Also, provide the JJ&ture of the legal ownership (i.e, par~M!Sbip. tenants m common. non-profit, corporation, n:.). If the ownership includes a corporation w wrtnershjp. include the names. title:. addresses of all individuals .ou'ning more lha.JS l00/11 of the shares. IF NO INPIVIDUALS OWN MORE THAN 10% OF THE SHAR»S. PLEAS£ INDICATE NON-APPLICABLE ~~A) IN TilE SPACE BELOW. If a J!.!!.blicly- ovmed eomoratigu,. incluac thl: names, titles, and addresses of the Qorporak offi¢trs. (A separate J)age may be at1ached ifneceJpry.) Pencm (~~I! Co~~·------------------------Title. _______________ _ Title _________________ _ Address'-----------~-Addr~ss. ______________ _ 1635 Faraday Avenue • Carlebad, CA 9~8·'7'3, 4 • (760) 602-~600 • FAX (760) 902·S!)S9 <i) FROM -·· FAX NO. :8587562051 411rug. 17 2005 11:21AM P2 • 08/IT/2005 11:05 FAI 7604380113 ,DEXTER WILSON ENG 't;ji ..-;;-.-l'."o"""o-.-t ---- lii!OOL"OOJ. 3. NON-PROFIT OR.G.ANIZATION OR. TRUST lf'any 'PCf$0f{ idC"ntitied pursuant to (1 ,) or c:n above: is a ngnprofit organization or a ttvft. lt;;t fn~ names and addresses of Am: person sen-in& as m officer or diTe~;tOr of the non-profil oTganization or a5 tru&tee or beneficiary of the. Non Profit/Tmst._ _______ _ Tttle·-------------------------Ad~·--------------------- Non Profit'Tru&t. __________ _ ·Titie. __________________________ _ A~~·--------------------------- 4. Ilave you had more than SlSO worth of busin£sa transacted ·with any·nwmber of City staff. B~>a:rds. Commissions. Commin~e& and/or Council within 'lM past twel,·e (12) months':' 0 Yes ~No If yes. please indicate person(s):. ___ ~------...... -~--~ NOT£: Attach additional sheets ifncc:essary. arion is true mtd correct to the best of my knowledge:. Print or type name of a-pplicant H!AOMIN\COUNTI!I'I\DISCLOSURE $TATSMENT 5198 Page 2 of 2 t; it of DISCLOSURE STATEMENT Applicant'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 following information MUST be disclosed at the time of application submittal. Your project cannot be reviewed until this information is completed. Please print. Note: Person is defmed as "Any individual, firm, co-partnership, joint venture, association, social club, fraternal organization, corporation, estate, trust, receiver, syndicate, in this and any other county, city and county, city municipality, district or other political subdivision or any other group or combination acting as a unit." Agents may sign this document; however, the legal name and entity of the applicant and property owner must be provided below. I. 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 PA ~ \ C.L \. t::; -HfL{.Jt_ Y Corp/Part. __________ _ Title OW 0 ft'Z. Title_-_____________ _ Address f.o, 6o~ -z ~ oq f)" Address _____________ _ £ tJ C t "-1 ITJI\-S C A-. q '2.0 '2-~ 2. OWNER (Not the owner's agent) 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_~_'A_"M_f_~A_<)........;....~~6'-o......;;~....::E'---Corp/Part ____________ __ Title ____________ _ Title ______________ _ Address ___________ _ Address, _____________ _ L-too$'" 1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (760) 602-4600 • FAX (760) 602-8559 @