HomeMy WebLinkAboutCUP 103B; Las Flores Church of the Nazarene; Conditional Use Permit (CUP)'FROM LQS FLORES CHURCH c FFlX NO. :
MAILING ADDRESS
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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
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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
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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
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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