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Home My WebLink AboutCUP 103B; Las Flores Church of the Nazarene; Conditional Use Permit (CUP)'FROM LQS FLORES CHURCH c FFlX NO. : MAILING ADDRESS l4?=%6Raze6 pfz. Ww,c4 %ax3 htJ729-0L3, CITY AND STATE 21 P TELEPHONE I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY -. Jun. 09 2003 08:51FIM P2 MAILING ADDRESS z15b d. ,FJ&Td: m. 303 CITY AND STATE ZIP TELEPHONE w 5lJ Dlffio, PA szw (ii't)Gqz-9595 . I CERTIFY THAT I AM THE LEGAL REPRESENTATlVE OF THE OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND 1) 0 0 a 0 a 0 0 0 0 0 CITY OF CAALSBAD LAND USE REVIEW APPLICATION (CHECK BOXES) APPLICATIONS APPLIED FOR: Administrative Permit - 2nd Dwelling Unit Administrative Variance Coastal Development Permit Conditional Use Permit Condominium Permit Environmental Impact Assessment General Plan Amendment Hillside Development Permit Local Coastal Plan Amendment Master Plan Non-Residential Planned Development Planned Development Permit (FOR DEPARTMENT r""""l0 0 0 0 0 0 (FOR DEPARTMENT Planned Industrial Permit Planning Commission Determination Precise Developmenr Plan Redevelopment Permit Site Development Plan Special Use Permit Specific Plan Obtain from Engineerinq Department Tentative Tract Map Variance Zone Change List other applications not 1 51 OWNER NAME (Print or TY;~) 16) APPLICANT NAME (Print or Type) I I 'FROM f LFlS FLORES CHURCH ccI- FFlX NO. : Jun. 09 2003 08: 52FlM P3 - 9) LOCAL FACILITIES MANAGEMENT ZONE ]I 1 1 ) NUMBER OF EXISTING [TI 12) PROPOSED NUMBER OF RESIDENTIAL UNITS RESIDENTIAL UNITS 14) PROPOSED IN0 OFFICE/ w] 15) PROPOSED COMM 1x1 SQUARE FOOTAGE SQUARE FOOTAGE 10) PROPOSED NUMBER OF LOTS 13) TYPE OF SUBDIVISION 18) PROPOSED SEWER FI USAGE IN EDU ADT wwhq: M.0 @ 'I 7) PROPOSED INCREASE IN 16) PERCENTAGE OF PROPOSED PROJECT IN OPEN SPACE 5uDhq : @3.\ 19) GROSS SITE ACREAGE 20) R.iING GENERAL 21) PROPOSED GENERAL PLAN DESIGNATION 22) EXISTING ZONING m FI 231 PROPOSED ZONING 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 COUNClL MEMBERS TO INSPECT AND ENTER THE PROPERTY THAT IS THE SUMECT OF THIS APPLICATION. IN€ CONSENT SIGN ATUM FOR CITY USE ONLY FEE COMPUTATION APPLICATION TYPE FEE REQUIRED I I I TOTAL FEE REQUIRED r I RECEIVED BY: t 1 DATE FEE PAID Form 16 RECEIPT NO. m PAGE 2 OF 2 FROM :-LFIS FLORES CHURCH FFlX NO. : - Jun. 09 2003 08:07FIM P19 PROJECT DESCRIPTION/EXPLANATION PROJECT NAME; Please describe fully the proposed project by application type. Include any details necessary to adequately explain the scope and/or operation of the proposed project. You may also include any background information and.supporting statements regarding the reasons for, or appropriateness of, the application. Use an addendum sheet if necessary. Project Descriptian 10/96 Page 1 of 1 FROM : LAS FLORES CHURCH - FAX NO. : c Jun. 09 2003 08:05RM Pi7 - City of Carlsbad DISCLOSURIE STATEMENT Applicant's statement or disclosure of ccrra& ownership interests an all applications which will require discrctionary action on the part of the City Council or any appointed Board, Commission or Committee. Thc following infortnation MUST be disclosed at the time of application submittal. Your project cannot be reviewed until this infotmation is completed, Please print Note: Person is defined as 4Ady individual, firm, co-parhership, joint venhUc, associaooq social club, fraternal organization, corptuatioq estate, mst, receiver, syndicate, io this d any other county, city and county; city rnunicipaliv, district or other political subdivision or any other group or combination acling as a unit" Agents may sign this document; however, thc legal name and entity of the applicant and propexty owner ut be provided belaw. 1. APPLICANT (Not the applicant's agent) Provide the COMPLETE, LEGAL names and addresses of && persons having a financial interest in the application. If the applicant hcludes a cornoration or Dartnershia, include the. names, title, addresses of all individuals owning more than 10% of the shares. ..IF- NO APPLICABLE (N/A) IN THE SPACE BELOW If a publicly-owned cornoration, include the names, titles, and addresses of the corporate officers. (A separate page may be attached if necessary.) Pen*n_l;bMId\/ < P=Q5wf 6AiW.t . Title Title Address%* d. INDIVIDUALS OWN MORE THAN 10% OF THE SHARES, PLEASE JNDICATE NON- CorpPart ihhd. 57 r.% Address &E3 Plfio, a qillo 2. OWNER (Not the owner's agent) t Provide the COMPLETE. LEGAL names and addresses of && persons having my ownership interest in the property involved. Also, provide the nature of the legal ownership (i.e, partnership, tenants in common, non-profit, corporation, ctc.). If the omasbip includes a cornoration or D artnershiD, 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 ("/A) IN THE SPACE BELOW. If a p&l!d!k owned cornration, include the names; titles, and addresses of the corporate offkers. (A separate page may be attached if necessary.) Title FTY*<AF Title Address lea7 cA"j GI.@- m.- Address Person Llw COrpPart m*P,cp( 9zo08 163s Faraday Avenue - Carlsbad. CA 92008-731 4 - (760) 602-4600 - FAX (760) 602-8559 @ -* FAX NO. : Jun. 09 2003 08:06RM PI8 - FROM : LAS FLORES CHURCH 3. SON-PROFIT ORGkVZATION OR TRUST Ifany person identified pursuant to (1) or (2) above is 9 nomrofit oraanization or a tnrst, list the names and addresses of ANY person serving as an offrcer or director of the non-profit organization or as trustee 3 Non Profiflrus Non ProfitfZiust % Tide Title Address Address &kZ,kH%S 4. Have you had more than $250. worth of business transacted with any member of City staff, Boards, Commissions, Committees andor Council within the past tweive (12) months? 0 Yes m~o If yes, please indicate person(s1: NOTE: Attach additional sheets if necessary. 1 cerrify that all the above information is me and correct to the best of my )IrjowIedga. L ~ppficantfdate X-TGY Stw4IL namc of owner Print or type namc of applicant Signature of owner/applicant's agent if applicable/date Print or type name of ownedapplicant's agent H:ADMIN\COUNTER\DlSCLOSURE STATEMENT 5/98 Page 2 of 2 FFlX NO. : Jun. 09 2003 08:10AM P24 FROM : LFlS FLORES CHURCH - City of Carlsbad UADOUS WASTE AND SUBSTANCES STATEMENT Consultation Of Lists of Sites Related To Hazardous Wastes (Cenificarion of CornpIimce with Government Code Section 65962.5) Pursuant IO State of California Government Code Secrion 65962.5, I have consulted the Hazardous Wastes and Substances Sites List compiled by the California Environmental Protection Agency and hereby cerci@ that (check one): WThe development project and any alternatives proposed in this application are not contained on c the lists compiled pursuant to Section 65962.5 of the State Government Code. n The development project and any alternatives proposed in this application a contained on the lists compiled pursuant to Secrion 65962.5 of the State Government Code. APPLICAhT PROPERTY OWNER Address of Site: 1400 m. I UUWD Local Agency (City and County): -& 0, *d w ow drf Assessor's book, page, and parcel number; ?&- I a= Pke C&ryM 3823 Specify list(s): Regulatory Tdentification Number: Date of List: AdmidCOUIIWVXuW~ 1635 Faraday Avenue Gprfsbad, CA 92008-731 4 - (760) 602-4600 FAX (760) 602-8559 @ City of Carlsbad 1635 Faraday Avenue Carlsbad CA 92008 Applicant: DOMINY & ASSOCIATES ARCHITECTS Description CUP0 103B Amount 41.07 Receipt Number: ROO40566 Transaction Date: 02/23/2004 Transaction Amount: 41.07 5938 02/23/04 0002 01 02 CEI" 41 07