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Home My WebLink AboutCUP 204E; Saint Patrick Parish School; Conditional Use Permit (CUP)CITY OF CARLSBAD LAND USE REVIEW APPLICATION 1) APPLICATIONS APPLIED FOR: (CHECKBOXES) (FOR DEPARTMENT USE ONLY) Administrative Permit Administrative Variance Coastal Development Permit Esl Conditional Use Permit | | Condominium Permit i | | Environmental Impact Assessment General Plan Amendment I | Hillside Development Permit Local Coastal Program Amendment Master Plan Minor Conditional Use Permit | I Non-Residential Planned Development Planned Development Permit JUB-flfftfpil loptoie 1 — 1 — Planned Industrial Permit Planning Commission Determination Precise Development Plan Redevelopment Permit Site Development Plan Special Use Permit Specific Plan Tpnt^tivp P^rpp' M^n Obtain from Engineering Department Tentative Tract Map Variance Zone Change List other applications not specified (FOR DEPARTMENT USE ONLY) 2) ASSESSOR PARCEL NO(S).: SQSjSR O - /Q j o>05~ 3"?O " 0 ^ 3) PROJECT NAME: ftunt 13O!Tnd< ^fiuTlSh School 4) BRIEF DESCRIPTION OF PROJECT: PmWlMlJ OQL fcvat 5) OWNER NAME (Print or Type)6) APPLICANT NAME (Print or Type) MAILING ADDRESS MAILING ADDRESS i Adams St.«feocS? CITY AND STATE ZIP TELEPHONE CITY AND STATE ,- Carl sbad '2h ZIP EMAIL ADDRESS:EMAIL ADDRESS: TELEPHONE 1 CERTIFY THAT 1 AM THE LEGAL OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE/AND CORRECT TO THE BEST OF MY KhfoWLEDGE. IGNATURE jM DAfE ' \ CERTIFY THAT 1 AM THE LEGAL REPRESENTATIVEOOF OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. 07 SIGNATURE DwOtnnV jiDaioi- DATE ' 7) BRIEF LEGAL DESCRIPTION oD ED, W/UST BE SUBMITTED PRIORNOTE: 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 4:00 P.M. Form 14 8) LOCATION OF PROJECT:A o go STREET ADDRESS ON THE BETWEEN (NORTH, SOUTH, EAST, WEST) Pto ft co SIDE OF AND Ao Onue (NAME OF STREET) (NAME OF STREET) 9) LOCAL FACILITIES MANAGEMENT ZONE 10) PROPOSED NUMBER OF LOTS 13) TYPE OF SUBDIVISION 16) PERCENTAGE OF PROPOSED PROJECT IN OPEN SPACE 19) GROSS SITE ACREAGE 22) EXISTING ZONING ENTZONE »l* Nfa V//t M «-/ 11) 14) 17) 20) 23) / NUMBER OF EXISTING RESIDENTIAL UNITS PROPOSED IND OFFICE/ SQUARE FOOTAGE PROPOSED INCREASE INADT EXISTING GENERAL PLAN PROPOSED ZONING Hi* A//* tf/fl Kur H\* (NAME OF STREET) 12) PROPOSED NUMBER OF RESIDENTIAL UNITS 15) PROPOSED COMM SQUARE FOOTAGE 18) PROPOSED SEWER USAGE IN EDU 21) PROPOSED GENERAL PLAN DESIGNATION 24) HABITAT IMPACTS IF YES, ASSIGN HMP# 25) 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£jJWE CONSENT TO EMtfcY FOR THIS FOR CITY USE ONLY FEE COMPUTATION APPLICATION TYPE FEE REQUIRED RECEIVED JAN 0 t\ 2007 OF CARLSBAD N RECEIVED RECEIVED BY: TOTAL FEE REQUIRED Form 14 City of Carlsbad Planning Department 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. Your project Note: Person is defined 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. 1. 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 DeCMS^L CLnoaCS Corp/Part Title rTirvQjLp* Address 3^2.0 3Ll PlO K ICO 1 Title V' Address Onrl^had , d A 9206? 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 Wl Title Corp/Part_ Title 1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (760) 602-4600 • FAX (760) 602-8559 • www.ci.carlsbad.ca.us 3. NON-PROFIT ORGANIZATION OR TRUST If any person identified pursuant to (1) or (2) above is a nonprofit organization 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 Profit/Trust Non Profit/Trust Title Title Address Address 4. Have you had more than $250 worth of business transacted with any member of City staff, Boards, Commissions, Committees and/or Council within the past twelve (12) months? I I Yes IS 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. Signature of owner/crate Signature of applicant/date UAlil'flm F P\o\jQland Peruse (?.Q^iTes 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