HomeMy WebLinkAboutPRE 2019-0014; TELESCOPE HOUSE; Preliminary Review (PRE)CITY OF CARLSBAD APPLICATION FORM
CITY USE O.NL Y {) () ~ "'w\ f 9 u
Project Number: r f--4-(:7'J --oo I , Development Number: ;).ol Cf-0 { 3
PROJECT NAME: (__ ..L--=-.....L....:~~""'-"lF----J..-=----'--A:,,'lc,l.....,___,.._'---------------------
A s s es so r's Parcel Number(s): oO 7 -1 i s-:J.0-6 0
Description of proposal (add attachment if necessary): \'--'\"-l~=---yJ.___s~: _n---,;~.+\ .... ,e __ ,,_. i;,.."-'--'-(Y)-'--'-\+~+---------
Would you like to orally present your proposal to your assigned staff planner/engineer? Yes D ~ □
Please list the staff members you have previously spoken to regarding this project. If none, please so state.
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OWNER NAME (Print): oc-e.1--hre
MAILING ADDRESS: :f 1 3 G I Vy tJz .... )
'l-J s{..J CITY, STATE, ZIP: OC;f'.A ~.[, ~ C:.../1 9Jo 1
TELEPHONE: 7 c;o ,:J, 1 1 o s d-VJ
EMAIL ADDRESS: e L, 'f-e bora (4,Q:51-r",,,tJ ~✓<t?»L '<J.
*Owner's signature indicates permission to conduct a preliminary
review for a development proposal.
I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE
ABOV INFORMATION IS TRUE AND CORRECT TO THE BEST 0: :?°WLEDGE. ? /p ~
SIG~ _1□4~c71r
APPLICANT NAME (Print): -----------MA I LING ADDRESS: -------------
CITY, STATE, ZIP:
TELEPHONE:
EMAIL ADDRESS:
I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE
OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE
AND CORRECT TO THE BEST OF MY KNOWLEDGE.
SIGNATURE DATE
APPLICANTS REPRESENTATIVE (Print): 1 -e_
MAILING ADDRESS: J ~ G / V ......... } .... ~....:.-...;. +--~:....L...,.;-----------------
CITY, STATE, ZIP: OGe°"n S, ~ CG '1 ao 5 <'-/
TELEPHONE: 7 c;o a 1 3 0 5 a ~
EMAILADDRESS: e.1,+e_ hofh-LConst (uG-4-,' oi-J® (b hoo. usf11
I
CESS OF REVIEWING THIS APPLICATION IT MAY BE NECESSARY FOR MEMBERS OF CITY STAFF TO INSPECT
RT PROPERTY THAT IS THE SUBJECT OF THIS APPLICATION. INVE CONSENT TO ENTRY FOR THIS PURPOSE.
PERTY OWNER SIGNATURE
REQUIRED/DATE FEE PAID: ,~ ,00
RECEIVED BY: ~
P-14 Page 3 of3 Revised 07117