HomeMy WebLinkAboutEIA 04-03; EL CAMINO REAL WIDENING; Environmental Impact Report (EIR)S -0 CITY OF CARLSBAD
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1) APPLICATIONS APPLIED FOR: (CHECK BOXES)
(FOR DEPARTMENT (FOR DEPARTMENT
LII Administrative Permit
LI Administrative Variance
IIJ Coastal Development Permit
LII Conditional Use Permit
LI Condominium Permit
Environmental Impact
Assessment
1111 General Plan Amendment
LII Hillside Development Permit
Local Coastal Program
Amendment
Master Plan
El Non-Residential Planned
Development
LI Planned Development Permit
Planned Industrial Permit
111111 Planning Commission
Determination
LIII Precise Development Plan
El Redevelopment Permit
El Site Development Plan
fl Special Use Permit
Specific Plan
[II Tentative Parcel Map
EI
Obtain from Engineering Department
Tentative Tract Map
Variance
LII Zone Change
LIII List other applications not
2) ASSESSOR PARCEL NO(S).: 2j2c_C't .-
3) PROJECT NAME: tL ç nttjz' wJ.!w1. (ftv'r. ç1& -
4) BRIEF DESCRIPTION OF PROJECT: wrdJ ¶2.cfc— -rC' f\L. Anflq. Pft.fc9.-. tnt-&4r4 -
5) OWNER NAME (Print or Type) 6) APPLICANT NAME (Print or Type)
CN\ or- cpg2-S$.i 1 94 Ct-nc C'P- &cc a4tca-re jc)
MAILING ADDRESS MAILING ADDRESS
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CITY AND STATE ZIP TELEPHONE CITY AND STATE ZIP TELEPHONE
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I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE I CERTIFY
INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY 8VR 4Eft*%9 THAT ALL THE ABOVE INFORMATION IS TRUE AND
KNOWLEDGE. CORRECT TO THE BEST OF MY KNOWLEDGE.
SIGNATURE DATE SIGNATURE EfATe
7) BRIEF LEGAL DESCRIPTION - 2-ti rW- t 1 S s-sr 21t1 -tc-'fl
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 4:00 P.M.
Form 16 Rev. 04iO4 PAGE 1 OF 2
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8) LOCATION OF PROJECT:
STREET ADDRESS
ON THE j f&cr-r SIDE OF I TEL CCt1,r-t' gEiL..
NORTH, SOUTH, EAST, WESTI (NAME OF STREETI
BETWEEN I ANDicaYC-t-C) cfA2425eJt I
(NAME OF STREET) NAME OF STREET)
9) LOCAL FACILITIES MANAGEMENT ZONE
10) PROPOSED NUMBER OF LOTS 11) NUMBER OF EXISTING 12) PROPOSED NUMBER OF
RESIDENTIAL UNITS RESIDENTIAL UNITS D
13) TYPE OF SUBDIVISION 14) PROPOSED IND OFFICE! , 15) PROPOSED COMM -,
SQUARE FOOTAGE I. SQUARE FOOTAGE C
16) PERCENTAGE OF PROPOSED 17) PROPOSED INCREASE IN 18) PROPOSED SEWER
PROJECT IN OPEN SPACE __ ADT ___ USAGE IN EDU U
19) GROSS SITE ACREAGE 20) EXISTING GENERAL 21) PROPOSED GENERAL
PLAN PLAN DESIGNATION
22) EXISTING ZONING 23) 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 COUNCIL MEMBERS
TO INSPECT AND ENTER THE PROPERTY THAT IS THE SUBJECT OF THIS APPLICATION. 1/wt LUNSNF
('171)
SIGNATURE U /
FOR CITY USE ONLY
FEE COMPUTATION
M;t'1*4IIIU1
CITY OF CARLSBAD
PLANNING DEPT.
DATE STAMP APPLICATION RECEIVED
RECEIVED BY:
TOTAL FEE REQUIRED
C1tC /Jeth
DATE FEE PAID RECEIPT NO. I
Form 16 Rev. 04104 PAGE 2 OF 2