HomeMy WebLinkAboutHDP 02-06; Tavelman Tennis Court; Hillside Development Permit (HDP) (8)... I I I
I.
-4.
City of Carlsbad
1635 Faraday Avenue Carlsbad CA 92008
Receipt
Applicant: TAVELMAN DANA
Description
HDP 0 2 0 0 6 155.00
Not valid unless validated by Cash Register PLEASE RETAIN RECEIPT FOR REmTNDS OR ADJUSTMENTS
Receipt Number: ROO28727
Transaction Date: 07/30/2002
Pay Type Met hod Description Amount _-_--_____ __________ ________________ __________
Payment Check 2853 155.00
Transaction Amount: 155.00
City of Carlsbad
1635 Faraday Avenue Carlsbad CA 92008
Applicant: TAVELMAN DANA
Description
HDP02006
Amount
51.06 CGF' 51. = 06
M89 10130/02 0002 01. 02
Receipt Number: ROO30632
Transaction Date: 10/30/2002
Pay Type Method Description Amount ___--___-_ __________ ________________ __________
Payment Credit Crd VISA 51.06
Transaction Amount: 51.06
* Applicant's statefflnrt or disclosure of wmin ownmhip intaestS on all applications wluch will rcquirC
disnetionary actian on tbc part of the City Coumduranyapp, iattdBoand, Commission wcommitke.
The following information MU- be disclosed at thc time of application submittal. Your pmject cannot bc reviewed until this information is can*ipl&. Please print.
1. MPucm mM thC W-6 pgcd) Provide Ihc mMPm LEGAL, names and addresses of persons having a financial
nanres, title, ackbscs of all individuals owning mon thon los'o of the shares. IF NO INDIVIDUALS OWN MORE THAN 10% OF THE SHARES, PLEASE INDICATE NON-
. include the names, titles, and addresses of the caporate officers. (A sepante page my bc attached if
interest in the apph&on. If the applicant iuclh a -as LU, include the
App]LICABLE (WA) IN THE SPACE BELOW If a
===Y*)
pasonDana A. Tavelman
Title &mer Title
Aes3315 Venado St, LaOoSb Additss
OWNER (Not the owner's agart) M&*CO~ AI, OIUMf and irddmsts of&perrons having any OwIlCrship
interest in the pmpa-ty involved. Atso, provide the nature of the legal bwnQsbtp (i.e,
parbedup, taunts in common, mn-profit, corporstion, etc.). If the ownership includes a
than 10% of the sh IF NO IND!VIDUALS OWN MORE "AN 10% OF THE SHARES, PWE INDICATE NON-APPLICABLE (IVA) IN THE SPACE BELOW. If a
OwnedcCrDora tion, include the names, titles, and addresses of thc rorporatc officers. (A separate
page may be uerchtd if mcessmy.)
92009
2.
$xxmatlonorDartnmlu 'D, hdL& th II(Lmts, title, Of i3a hdiVidualS mOre
Pmioa sameasabove corp/part
Title Title
A* Address
1635 Faraday Avenue Carlsbad. CA 92008-7314 - (760) 6029600 FAX (760) 602-6559 @
.# vu .W... .-.. C. -11. ,... ."'-1. .Y. ".Y.WIY. c 1' --$ *' - . .- - -
-7 3. NON-PROFIT C .SA"ION OR "RUST
If arry person identified pursuaat to (1) or (2) above is a nommfi torean ization or a mst. list the
names ad lddrrrses of ANy pnson serving as an officer or director of the ~on-pr~fit
organhtion or as hwta w beneficiary of the.
Title Title . .
Address. Address
4. H8vt you bad more than $250 worth ofbusiness trimwkd with any member of City aff,
0 Yes No If- please indicate person($):
Boards, c0In-w ccnlmli- dw Cod within the past twelve (It) months?
I catifythat all the above information is true and oomcttothbtstofmy knowledge.
Dana A. Tavelman
Print or typenome of own- Print otrype uamc of applicant
R, ' Enuineer ing, Inc. Print or *name of o~dappii~t~~t's agent
H~DMlMCOUMER\DISCLOSURE STAYEMENT 6/98 Page 2 of 2
760 635 9363; J~l-25~2 4: 23PM; Page 2/4 Sent By: JACK AND DANA TAVELMAN:-
87/25/2002 13!33 76094% a WIEGUITO ENG ?&G€ u2
, HAZARDQUS WASTE APJD SUBSTANCES STATEMENT . .
a I 0W 280.0 1
... ._ .: . -. : -. .: ,i . ,. ......... . : ... ... ... . ...> .. .... ..
......
2 .. ..
I 214756 STATE OF CALIFORNIA - THE RESOURCES AGENCY
DEPARTMENT OF FISH AND GAME
OFG 753,s (6-01)
Project Applicant Addres
Project Applicant (check appropriate box): Local Public Agency
CHECK APPLICABLE FEES:
( ) Environmental Impact Report $850.00 $
( ) Negative Declaration $1,250.00 $
( ) Application Fee Water Diversion (State Water Resources Control Board Only) $850.00 $
( ) Projects Subject to Certified Regulatory Programs $850.00 $
( ) County Administrative Fee $25.00 $ deject that is exempt from fees
TOTAL RECEIVED $ A?
I@ OLDENROD-STATE AGENCY OF FILING
Signature and title of person receiving payment: mh cz
WHITE-PROJECT APPLICANT YELLOW-DFGIFASB PINK-LEA0 AGENCY