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HomeMy WebLinkAboutCUP 139Ax1; St. Elizabeth Seton Catholic Church; Conditional Use Permit (CUP)- CITY OF CARLSBAD u List other applications not LAND USE REVIEW APPLICATION 1) APPLICATIONS APPLIED FOR: (CHECK BOXES) (FOR DEPARTMENT USE ONLY) (FOR , DP&?.?.?TLlT 0 Administrative Permit - 2nd 0 Administrative Variance Dwelling Unit 0 0 0 0 E o 0 Planned Industrial Permit Planning Commission Determination Precise Development Plan Redevelopment Permit Site Development Plan Special Use Ferrnit Specific Plan Obtain from Engineering 0 Coastal Development Permit [;d Conditional Use Permit 0 Condominium Permit LJ Environmental Impact Assessment u General Plan Amendment z] Hillside Development Permit Department Tentative Tract Map _I Local Coastal Plan 4mendment 7 Master Plan 7 Non-Residential Planned Development 0 Variance Zonechange Planned Development Permit 2) ASSESSOR PARCEL NO(S).: 26-530 b c 3) PROJECT NAME: 5t. a\mb& s &hn C&\lcClnu dk i&L &At& fadKw 4) BRIEF DESCRIPTION OF PROJECT: b\LL Pa.C 5) OWNER NAME (Print or Type) -VAL &&A L%\k b&bP d; SWLble4Q 6) APPLICANT NAME (Print or Type) ~ MAILING ADDRESS 4.0. k W?2X MAILING ADDRESS CITY AND STATE ZIP TELEPHONE 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. I CERTIFY *AT I AM THE LEGAL OWNER AND THAT ALL THE/BBOVE INFORMATION IS TRUE AND KNOW LEDGE. Form 16 SIGNATURE DATE s I ~ITURE DATE 7) BRIEF LEGAL DESCRIPTION NOTE: A PROPOSED PROJECT REQUIRING MULTIPLE APPLICATIONS BE FILED, MUST BE SUBMITTED PRIOR TO 3:30 P.M. A PROPOSED PROJECT REQUIRING ONLY ONE APPLICATION BE FILED, MUST BE SUBMITTED PRIOR TO 4:OO P.M. Form 16 c , '. 8) LOCATION OF PROJECT: WEST) :NAME OF STREET) I EL FU~iZTd ST BETWEEN I RD AND I I (NAME OF STREET) 9) LOCAL FACILITIES MANAGEMENT ZONE I 11) NUMBER OF EX1 STI NG RESIDENTIAL UNITS 14) PROPOSED IND OFFICE/ SQUARE FOOTAGE U 10) PROPOSED NUMBER OF LOTS 13) TYPE OF SUBDIVISION U NUMBER OF RESIDENTIAL UNITS n 15) FROPOSED COMM SQUARE FOOTAGE U 18) PROPOSED SEWER USAGE IN EDU 17) PROPOSED INCREASE IN ADT 16) PERCENTAGE OF PROPOSED PROJECT IN OPEN SPACE 21) PROPOSED GENERAL PLAN DESIGNATION 19) GROSS SITE ACREAGE 20) EXISTING GENERAL 22) EXISTING ZONING 23) PROPOSED 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 APPLICATION. lMlE CONSENT TO ENTRY FOR THIS PURPOSE FOR CITY USE ONLY FEE COMPUTATION APPLICATION TYPE FEE REQUIRED Form 16 RECEIVED h \ TOTAL FEE REQUIRED 11 DATE FEE PAID RECEIVED BY: I RECEIPT NO. Form 16 City of Carlsbad 1635 Faraday Avenue Carlsbad CA 92008 Applicant: ST ELIZABETH SETON CATHOLIC CHURCH Description SWPPO405 Amount 680.00 \ Receipt Number: ROO44496 Transaction Date: 08/16/2004 c City of Carlsbad 1635 Faraday Avenue Carlsbad CA 92008 - Applicant: ST ELIZABETH SETON CATHOLIC CHURCH DescriDtion Amount CUP139Axl Receipt Number: ROO41650 Transaction Date: 04/14/2004 Transaction Amount: 315.98 City of Carlsbad 1635 Faraday Avenue Carlsbad CA 92008 Applicant: ST ELIZABETH SETON CATHOLIC CHURCH DescriDtion CUP139Axl Amount 595.00 Receipt Number: ROO38935 Transaction Date: 12/05/2003 Pay Type Met hod Description Amount __________ __________ ________________ _________- Payment Check 8448 595.00 Transaction Amount: 595.00 0371 u/05/03 0002 Of. 02 CGP 595 * 00 - City of Carlsbad 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. cannot be reviewed until this information is completed. Please print. Note: Person is defined as "Any individual, firm, co-partnsrship, 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.". Your project Agents may sign this document; however, the legal name and entity of the applicant and property owner must be provided below. 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 includes a corporation or partnership, include the names, title, addresses of all individuals owning more than 10% of the shares. IF NO INDIVIDUALS 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.) OWN MORE THAN 10% OF THE SHARES, PLEASE INDICATE NON-APPLICABLE (N/A) IN THE 2. OWNER (Not the owner's agent) Provide the COMPLETE, LEGAL names and addresses of 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.) 1635 Faraday Avenue e Carlsbad, CA 92008-7314 (760) 602-4600 FAX (760) 602-8559 www.ci.carlsbad.ca.us @ +. -4 3. NON-PROFIT ORGANIZATION OR TRUST If any person identified pursuant to (1) or (2) above is a nonprofit orqanization or a trust, list 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 Profitrrrust kbbtc-f- fi I b fi Non Profitrrrust Title 6khP e& ‘6Mbko Title Address QO. ’ih<S?!l..‘ij Address QEeA0! CA 99\#b-S?2% 4. Have you had more than $250 worth of business transacted with any member of City staff, Yes NO ii yes, piease indicate personjs): Boards, Commissions, Committees and/or Council within the past twelve (1 2) months? NOTE: Attach additional sheets if necessary. I certify that all the above information is true and correct to the best of my knowledge. Sign at u re of a pp lica nt/date ~hb hu L!a\fo G&P C& &ut Print or type name of owner v”4” Print or type name of applicant Print or type name of ownerrapplicant’s agent -------- - AUC-05-2004 THU 11 :43 AH CARLSBAD EKINEERlNG FAX NU, IUU tsuz IU~L PhoneNumber: -E-- &Mail; Fax Number. - State Registration Numk - .I