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Home My WebLink AboutPIP 01-03; Palomar Forum; Planned Industrial Permit (PIP)* CITY OF CARLSBAD LAND USE REVIEW APPLICATION APPLICATIONS APPLIED FOR: (CHECK BOXES) (FOR DEPARTMENT USE ONLY) Administrative Permit - 2nd Dwelling Unit Administrative Variance Coastal Development Permit Conditional Use Permit Condominium Permit Environmental Impact Assessment Gs;ier;,; P:zn kmx"dmer;r I Hillside Development Permit I w 0 0 0 0 0 IO Local Coastal Plan Amendment Master Plan Non-Residential Planned Development 0 0 0 n Planned Development Permit I Planned Industrial Permit (FOR DEPARTMENT Planning Commission Determination Precise Development Plan Redevelopment Permit Site Development Plan I Special Use Permit I I Specific Plan Obtain from Engineering Department Tentative Tract Map Variance I Zone Change List other applications not I I specified 2) ASSESSOR PARCEL NO(S).: 221-010-17 & 221-012-10 3) PROJECT NAME: Palomar Forum 4) BRIEF DESCRIPTION OF PROJECT: PIP to accompany CT and HDP applications for industrial lots 5) OWNER NAME (Print or Type) I 6) APPLICANT NAME (Print or Type) Palomar Melrose, LLC Palomar Melrose, LLC MAILING ADDRESS 990 Highland Drive, Suite 320 CITY AND STATE ZIP 990 Highland Drive, Suite 320 Solana Beach, CA 92075 (858) 755-061 5 Solana Beach, CA 92075 (858) 755-0615 MAILING ADDRESS TELEPHONE CITY AND STATE ZIP TELEPHONE I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE KNOWLE3GE. OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND INFI?Rh?A.TION IS TRUE AND CORRECT TO THE BEST OF MY I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE 94 & +/tA -21 !!!..! "" ~- q/. /B k* CORRECT TO THE BEST OF MY KNOWLEDGE. SIGNATURE DATE SIGNATURE DAlf 7) BRIEF LEGAL DESCRIPTION Portions of Section 18, Township 12 South, Range 3 West, San Bernardino Meridian, in the City of Carlsbad .s>e-c/ qq ()( 3 N&E: A PF~OPOSED PN~JECT REQU~H#~~%'MULT~PLE APPLICATIONS BE FILED, MUST BE SUE~~I~TED ~~iiok Yo ~:~o,P.M. .< I A PROPOSED PROJECT REQUIRING ONLY 'ONE APPLICATION BE FILED, MUST BE SUBMITTED PRIOR TO'4:OO P.M. Form 16 PAGE 1 OF 2 LOCATION OF PROJECT: k, STREET ADDRESS ON THE Palomar Airport Road SIDE OF North (NORTH, SOUTH, EAST, WEST) (NAME OF STREET) BETWEEN Future Melrose Drive AND Business Park Drive (NAME OF STREET) (NAME OF STREET) LOCAL FACILITIES MANAGEMENT ZONE 18 PROPOSED NUMBER OF LOTS 1 12 I 11’ TYPE OF SUBDIVISION I IND I 14) PERCENTAGE OF PROPOSED PROJECT ibl OPEN SPACE GROSS SITE ACREAGE 20) EXISTING ZONING I P-M I 23) NUMBER OF EXISTING 12) RESIDENTIAL UNITS PROPOSED IND OFFICE/ SQUARE FOOTAGE EXISTING GENERAL PLAN PROPOSED ZONING El PROPOSED NUMBER OF 1 orno I RESIDENTIAL UNITS PROPOSED COMM SQUARE FOOTAGE PROPOSED SEWER USAGE IN EW m PROPOSED GENERAL PLAN DESIGNATION 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. I/WE CONSENT TO ENTRY FOR THIS PURPOSE FOR CITY USE ONLY FEE COMPUTATION APPLICATION TYPE FEE REQU!RED PX P $3,060 I TOTAL FEE REQUIRED 3,wo DATE FEE PAID Form 16 1 RECEIPT NO. I I PAGE 2 OF 2 City of Carlsbad 1635 Faraday Avenue Carlsbad CA 92008 Applicant: PALOMAR MELROSE L L C Description PIP01003 Amount 3,060.00 Receipt Number: ROO18564 Transaction Date: 02/21/2001 Pay Type Method Description Amount """"" """"" """""""" """"" Payment Check 9962 280.00 Payment Check 9961 2,780.00 Transaction Amount: 3,060.00 I f City of Carlsbad DISCLOSURE STATEMENT I Applicant’s statement or disclosure of certain ownership interests on all applications which will require I I discretionary 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 defmed as “Any individual, firm, co-partnership, joint venture, association, social club, fiaternai organization, corporation, estate, trust, receiver, syndicate, in this and my other county, city and county, city municipality, &strict 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 comoration or uartnershiu, 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 comoration, include the names, titles, and addresses of the corporate officers. (A separate page may be attached if necessary.) Person coq’p&Palomar Melrose, LLC INDIVIDUALS OWN MORE THAN 10% OF THE SHARES, PLEASE INDICATE NON- Title Title Address Address 990 Highland Drive Solana Beach, CA 92075 2. OWNER (Not the owner’s agent) Provide the COMPLETE. LEGAL names and addresses of 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 comoration or Dartnershiu, 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- owned comoration, include the names, titles, and addresses of the corporate officers. (A separate page may be attached if necessary.) Person corp/part Palomar Melrose, LLC Title Title Address Address 990 Highland Drive Solana Beach, CA 92075 1635 Faraday Avenue - Carlsbad, CA 92008-7314 - (760) 602-4600 - FAX (760) 602-8559 @ ~~ ~~~~~~~ - 3. NON-PROFIT C SANIZATION OR TRUST If any person identified pursuant to (1) or (2) above is a nonmofit 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 ProfiVI‘rust Non ProfiVI’rust 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 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. 9A.A c L 4 Signature of ownerldate Signature of applicantldate 9A.A c L 4 Signature of ownerldate Signature of applicantldate Pnnt or type name of owner Print or type name ofiiilicant Signature of ownerlapplicant’s agent if applicableldate Print or type name of ownerlapplicant’s agent H:ADMIN\COUNTER\DISCLOSURE STATEMENT 5/98 Page 2 of 2 ~~ ~~~ ~ ~...