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Home My WebLink AboutHDP 01-06; St. Amour Residence; Hillside Development Permit (HDP) (2)1 CITY OF CARLSBAD LAND USE REVIEW APPLICATION APPLICATIONS APPLIED FOR: (CHECK BOXES) Adpinistrative Permit. - 2nd Dwelling Unit I4. Administrative Variance Coastal Development Permit 't Conditional Use Permit Condominium Permit Environmental Impact Assessment General Plan Amendment s. Hillside Development Permit Local Coastal Plan Amendment Master Plan <I Non-Residential Planned Development Planned Development Permit (FOR DEPARTMENT USE ONLY) I 2) ASSESSOR PARCEL NOW.: - Planned Industrial Permit I, Planning Commission Determination Precise Development Plan Redevelopment Permit Site Development Plan Special Use Permit Specific Plan . *I ''* Tentative Tract Map Variance I Zone Change List other applications not (FOR DEPARTMENT USE ONLY) 1 5) OWNER NAME (Print or Type) K 4 mWWY S7, AMOUR MAILING ADDRESS I CERTIFY THAT I AM HE LEGAL OWNER AND THAT ALL THE ABOVE INFORMATION AS TRUE AND CORRECT TO THE BEST,OF MY KNOWLEDGE 6) APPLICANT NAME (Print or Type) bbEIAI.8 6mUGB ACLeHI 764f 2107 NW CRWAW. me CAmC 6 CAI -7 t76a)qWM MAILING ADDRESS CITY AND STATE ZIP TELEPHONE I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE OWNER AND THAT ALL THEABOVE INFORMATION IS TRUE AND Y KNOWLEDGE. g.U-OJ SIGNATURE DATE 7) BRIEF LEGAL DESCRIPTION NOTE: A PROPOSED PROJECT REQUIRING M A PROPOSED PROJECT REQUIRING ONLY ONE APPLICATION BE FILED, MUST BE SUBMllTED PRIOR TO 4:OO P.M. Form 16 I S 05Qgg 1 OF 2 8) LOCATION OF PROJECT: STREET ADDRESS - VIrn PQ, (NAME OF STREET) ONTHE 7 SIDEOF I& (NORTH, SOUTH,&&& WEST) TOTAL FEE REQUIRED AND 01911 901766 QL I (NAME OF STREET) (NAME OF STREET) BETWEEN IAMh RO. $W SIS I 9) LOCAL FACILITIES MANAGEMENT ZONE TI 12) PROPOSED NUMBER OF I 9 1 RESIDENTIAL UNITS 15) PROPOSED COMM 191 SQUARE FOOTAGE 11) NUMBER OF EXISTING I 1 RESIDENTIAL UNITS /R.’3) SQUARE FOOTAGE 10) PROPOSED NUMBER OF LOTS 14) PROPOSED IND OFFICE/ 13) TYPE OF SUBDIVISION 17) PROPOSED INCREASE IN I 9 1 18) LEg’SFEFuWER Ilook( ADT 16) PERCENTAGE OF PROPOSED PROJECT IN OPEN SPACE 19) GROSS SITE ACREAGE 21 ) PROPOSED GENERAL I Rd PLAN DESIGNATION 22) EXISTING ZONING m 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 IS THE SUBJECT OF THIS APPLICATION. I/WE CONSENT SIGNATURE FOR CITY USE ONLY .I FEE COMPUTATION ti RECEIVED ‘9: . ‘ APPLICATION TYPE FEE REQUIRED’ APR 0 2‘2001 A. CITY OF CARCSBAD DATE “ANNMQWNLCE~VED DATE FEE PAID Form 16 RECEIPT NO. I1 PAGE 2 OF 2 PLEASE NOTE: Time limits on the processing of discretionary projects established by state law do not start until a project application is deemed complete by the City. The City has 30 calendar days from the date of application submittal to determine whether an application is complete or incomplete. Within 30 days of submittal of this application you will receive a letter stating whether this application is complete or incomplete. If it is incomplete, the letter will state what is needed to make this application complete. When the application is complete, the processing period will start upon the dafte of th-ompletion letter. Applicant Signature: c Staff Signature: . To be stapled with receipt to application . Copy for file City of Carlsbad 1635 Faraday Avenue Carlsbad CA 92008 Applicant: GROVER DONALD DescriDtion HDP01006 Receipt Number: ROO19392 Transaction Date: 04/02/2001 Transaction Amount: 815.00 PROJECT DESCRIPTIONIEXPLANATION PROJECT NAME: AMWcL - ID- APPLICANT NAME: Lb aSWWL A=l))tT#~r- 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. Description/Explanation: Project Description 10/96 Page 1 of 1 - - City of Carlsbad DISCLOSURE STATEMENT I Applicant’s statement or disclosure of certain ownership interests on all applications which will require 1 ldiscretionary action on the part of the City Council or any appointed Board. Commission or Committee. I The following information MUST be disclosed at the time of application submittal. Your project cannot be reviewed until this information is completed. Please print. 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 persons having a financial interest in the application. If the applicant includes a corporation or DartnershiD, 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 publiclv-owned corporation, include the names, titles, and f the corporate officers. (A separate page may be attached if INDIVIDUALS OWN MORE THAN 10% OF THE SHARES, PLEASE INDICATE NON- COrpPart Title 2. OWNER mot 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 UartnershiD, 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 publiclv- es, and addresses of the corporate officers. (A separate CorpPart Title Address /.-frJ,&%dB“u Address e/ PLOBBIC 1635 Faraday Avenue Carlsbad, CA 92008-731 4 (760) 602-4600 FAX (760) 602-8559 @ - 3. NON-PROFIT RGANIZATION OR TRUST If any person identified pursuant to (1) or (2) above is a nonurofit Organization or a trust. 1st 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 Profiflmst Non Profiflmst Title Title Address Address 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 twelve (12) months? 0 Yes Ro If yes, please indicate person(s): NOTE: Attach additional sheets if necessary. ~~ Signature of oGer/applicanG-agent if applicableldate 1- Print or type name of owner/applicant’s agent H:ADMIN\COUNTER\DISCLOSURE STATEMENT 5/98 Page 2 of 2 ,. City of Carlsbad HAZARDOUS WASTE AND SUBSTANCES STATEMENT Consultation Of Lists of Sites Related To Hazardous Wastes (Certification of Compliance with Government Code Section 65962.5) Pursuant to State of California Government Code Section 65962.5, I have consulted the Hazardous Wastes and Substances Sites List compiled by the California Environmental Protection Agency and hereby certify that (check one): The development project and any alternatives proposed in this application are not contained on the lists compiled pursuant to Section 65962.5 of the State Government Code. 0 The development project and any alternatives proposed in this application are contained on the lists compiled pursuant to Section 65962.5 of the State Government Code. APPLICANT PROPERTY OWNER Address of Site: 72 I am lAgn Dh & Local Agency (City and County): CAW AD, c a Assessor’s book, page, and parcel number: Specify list(s): 1 I 2 IC -0 dbII - E Regulatory Identification Number: b Date of List: 1635 Faraday Avenue Carlsbad, CA 92008-7314 (760) 602-4600 0 FAX (760) 602-8559 @