The URL can be used to link to this page

Home My WebLink AboutCUP 02-18; TAMARACK VERIZON - 2ND EXTENSION; Conditional Use Permit (CUP)(city of Carlsbad --' LAND USE REVIEW APPLICATION P-1 Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.gov APPLICATIONS APPLIED FOR: (CHECK BOXES) Development Permits (FOR DEPT. USE ONLY) Legl•letive Permits • Coastal Development Permit •Minor Ii:] 1, ... J.. Conditional Use Permit -9',~lttJ •Minor Ii] Extension f1,tl.·• • Day Care (Large) • Environmental Impact Assessment • Habitat Management Permit •Minor • HIiiside Development Permit OMinor • Nonconforming Construction Permit • Planned Development Permit •Minor D Residential D Non~esidential • Planning Commlsalon Determination • Reasonable Accommodation • Sita Develop~ Plan D Minor • Special Use Permit • Tentative Pa"'81 Map (Minor Subdivision) • Tentative Tract Map (Major Subdlvlalon) • Variance OMinor CA,,'102,t~X\ D General Plan Amendment D Local Coastal Program Amendment D Master Plan 0 Specllic Plan D Zone Change •Amendment ) •Amendment D Zone com{ Amendment South Cartsbad Coastal Review A/'N Penn/ls D Review Permit D Administrative D Minor D Major Vlll!fl! Review A,u Penn/ta D Review Permit D Administrative D Minor D Major (FOR DEPT. USE ONLY) NOTE: A PROPOSED PltOJECT REQUIRING APPLICATION SUBMITTAL MUST BE SUBMITTED BY APPOINTIENT"'. PLEASE CONTACT THE APPOINTIENT SPECIALIST AT (780) IO:Z.2728 TO SCHEDUJ! AN APPOINTMENT. --&AMI! DAY APPOINTMENTS ARE NOT AVAILABLE ASSESSOR PARCEL NO(S): LOCATION OF PROJECT: NAME OF PROJECT: BRIEF DESCRIPTION OF PROJECT: PROJECT VALUE (SITE IMPROVEMENTS) FOR CITY USE ONLY 207-101-24 4899A El Camino Real, Carlsbad, CA 92008 (STREET ADDRESS) Verizon Site Name Tamarack CUP Extension CUP Extension of existing Verizon site located at 4899A El Camino Real, Carlsbad, CA ESTIMATED COMPLETION DATE Development No. 1J f,. J I> J,O '!'.) LeadCaaeNo. P-1 Page 1 of6 Revtoed 03117 OWNER NAME (PLEASE PRINT) APPLICANT NAME (PLEASE PRINT) INDIVIDUAL NAME INDIVIDUAL NAME (~ applicable): Marja Dawn Selna (if applicable): Verizon Wireless COMPANY NAME COMPANY NAME ~ wr\UtWA--5M I., (if applicable): Hoffman Legacy Trust (if applicable): !11 ~ MAILING ADDRESS: 6284 Forester Dr. MAILING ADDRESS: 15505 Sand Canyon~Avl. p:j_. CITY, STA TE, ZIP: Huntington Beach, CA 92648 CITY, STA TE, ZIP: Irvine, CA 92618 TELEPHONE: 714-742-1201 TELEPHONE: 949-556-7060 EMAIL ADDRESS: marjaacres@socal.rr.com EMAIL ADDRESS: ehiggins@tectonicengineering.com I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE OWNER INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO KNOWLEDGE. I CERTIFY AS LEGAL OWNER THAT THE APPLICANT AS THE BEST OF MY KNOWLEDGE. SET FORTH HEREIN IS MY AUTHORIZED REPRESENTATIVE FOR PURPOSES OF THIS APPLICATION. I ~ f'-.fJ.,t.~Ull. ~ ~ I,--SIGNATUR ~ 1/.:z D lg' DATE/ SIGNATURE DATE APPLICANT'S REPRESENTATIVE (Print): Emanuel Higgins, Tectonic Engineering MAILING ADDRESS: 1420 Bristol Street North, Suite 210 CITY, STATE, ZIP: Neweort Beach, CA 92660 TELEPHONE: 949-556-7060 EMAIL ADDRESS: ehiggins@tectonicengineering.com I CERTIFY THAT I AM THE REPRESENTATIVE OF THE APPLICANT FOR PURPOSES OF THIS APPLICATION AND THAT ALL THE ABOVE INFORMATION IS TRUE AND C~ BEST OF MY ~7•9"~ V-o-If _NA RE -;;._ DATE IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE NECESSARY FOR MEMBERS OF CITY STAFF, PLANNING COMMISSIONERS OR CITY COUNCIL MEMBERS TO INSPECT AND ENTER THE PROPERTY THAT IS THE SUBJECT OF THIS APPLICATION. I/WE CONSENT TO ENTRY FOR THIS PURPOSE. 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 LAND AND BIND ANY SUCCESSORS IN INTEREST. I 1n,~~~A= ROPERTY OWNER SIGNATURE FOR CITY USE ONLY DATE STAMP APPLICATION RECEIVED RECEIVED BY: P-1 Page 2 of6 Revised 03117 - OWNER NAME (PLEASE PRINT) APPLICANT NAME (PLEASE PRINT) INDIVIDUAL NAME INDIVIDUAL NAME (If applicable): Marja Dawn Selna, Trustee (W applicable): Verizon Vl/ireless COMPANY NAME COMPANY NAME (If applicable): Hoffman Legacy Trust (W applicable): MAILING ADDRESS: 6284 Forester Dr MAILING ADDRESS: 15505 Sand Csn:ton Road CITY, STATE, ZIP: HuntinEn Beach, CA 92648 CITY, STATE, ZIP: Irvine, CA 92618 TELEPHONE: 714-742-1201 TELEPHONE: 949-556-7060 EMAIL ADDRESS: marjaacres@socal.rr.com EMAIL ADDRESS: ehlggins@tectonicengineering.com I CERTIFY THAT I M1 THE LEGAL OWNER AND THAT ALL THE ABOVE I CERTIFY THAT I M1 THE LEGAL REPRESENTATIVE OF THE OWNER INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY ANO THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO KNOWLEDGE. I CERTIFY AS LEGAL OWNER THAT THE APPLICANT AS THE BEST OF MY KNOWLEDGE. SET FORTH HEREIN IS MY AUTHORIZED REPRESENTATIVE FOR pd,1 P RPOSES OF THIS APPLICATION. -~--~ .--7 ~A,11,t1t,AR.&{t _ 2-15-2018 3-Ze-{Z__ DATE er , GO -· DATE sib TU ' -C. -·· ' APPLICANT'S REPRESENTATIVE (Print): Emanuel Hi!i!!lins, Tectonic Engineeriri'!! MAILING ADDRESS: 1420 Bristol Street North, Suite 210 CITY, STATE, ZIP: NewPOrt Beach, CA 92660 TELEPHONE: 949-556-7060 EMAIL ADDRESS: ehi!!llins@tectonicen11ineerin1l.com I CERTIFY THAT I M1 THE REPRESENTATIVE OF THE APPLICANT FOR PURPOSES OF THIS APPLICATION AND THAT ALL THE ABOVE . INFORMATION IS TRUE ANO CORRECT TO THE BEST OF MY KNOWLEDGE. V 711 ~ &,t11. ~ti,.,,.,, ~-15•.M/8 SIGNATU DATE IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE NECESSARY FOR MEMBERS OF CITY STAFF, PLANNING COMMISSIONERS OR CITY COUNCIL MEMBERS TO INSPECT AND ENTER THE PROPERTY THAT IS THE SUBJECT OF THIS APPLICATION. l!WE CONSENT TO ENTRY FOR THIS PURPOSE NOTICE OF RESTRICTION: PROPERTY CM/NER 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 LAND AND BIND ANY SUCCESSORS IN INTEREST. PROPERTY OWNER SIGNATURE FOR CllY USE ONLY P-1 J>aue2ol6 MAR :t 9 2018 c,.1 \ , ... ,,1.SFlflD fJL1\ '-,, C\•., DIVISION DATE STAMP APPLICATION RECEIVED RECEIVED BY: Revioed 03117 - ~~· .. · .. '~ CITY OF DISCLOSURE STATEMENT P-1(A) Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.gov CARLSBAD 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. J Nole: Person Is defined as "Any individual, firm, co,-partoershlp, Joint venture, assoeiatlon, social club, fraternal organization, corporation, estate, trust, receiver, syndicate, In this and lllJY other county, city and county, city municipality, district or other pofltical subdivision or any other group efr 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. · 1. 2. P-1 (A) APPLICANT (Not the applicant's agent) Provide the COMPLETE. LEGAL names and addresses of AbL persons having a financial interest in the application. If the applicant includes a corporation or partnership. include the names, titles, 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 ~ Corp/Part~-lt.lf'l~rt-=F"',.------- Title\ t Ti~ __ N'f~_\·_,_ __ _ Address (.?'C, {/ly.,";;(,r ~d~s __________ _ OWNE (Not~ owner's Jg~r O °<-1 Provide the COMPLETE. LEGAL names and addresses of 81.J. 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, titles, 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 Marja Dawn Seine Corp/Part. __________ _ Tille Trustee, Hoffman Legacy Trust nue _____________ _ Address 6284 Forester Dr Address ___________ _ Huntington Beach, CA 92648 Page 1 of2 Revlood 07110 3. NON-PROFIT ORGANIZATION OR TRUST If any person identified pursuant to (1) or (2) above is a nonprofit organization or a trust, fist 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 Marja Dawn Selna Non Profit/Trust. _________ _ Title Trustee, Hoffman Legacy Trust Address 6284 Forester Dr Huntington Beach, CA 92648 TiUe. _____________ _ Address. ___________ _ 4. Have you had more than $500 worth of business transacted with any member of City staff, Boards, Commissions, Committees and/or Council withinJthe past twelve (12) months? ' Oves B;j 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. / .,/ I 1t'4fi ¼ut&)t~ ~-/5-:Lo/8 Signal e of owner/date Signature of a Marja Dawn Selna 1 le1V1 Z-#1. W1 ~ Print or type name of owner Print or type name of applicant Signature of owner/applicant's agent if applicable/date Print or type name of owner/applicant's agent P-1 (A) Pago2of2 Rovlud 07110