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HomeMy WebLinkAboutEIA 04-03; EL CAMINO REAL WIDENING; Environmental Impact Report (EIR)S -0 CITY OF CARLSBAD S LMNU Ut IWVICVV MVUUMIIUN 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 fj4(C(4fl' jltC_ rczccc t CITY AND STATE ZIP TELEPHONE CITY AND STATE ZIP TELEPHONE Ctfc&j5 c-ct fl &O2-Z%f a&ss 92vo'j/ k2.-t144 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 S 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