HomeMy WebLinkAbout2001-12-19; Planning Commission; ; CUP 01-06|CDP 01-18|SDP 80-11D - KING'S FISH HOUSE-"-' '~ ·,he City of Carlsbad Planning Departmem.
A REPORT TO THE PLANNING COMMISSION
P.C. AGENDA OF: December 19, 2001
Item No.@
Application complete date: October 4, 2001
Project Planner: Van Lynch
Project Engineer: Jeremy Riddle
SUBJECT: CUP 01-06/CDP 01-18/SDP 80-ll(D) -KING'S FISH HOUSE -Request for
the recommendation of adoption of a Negative Declaration and the
recommendation of approval for a Conditional Use Permit and Coastal
Development Permit and the approval of a Site Development Plan Amendment to
construct a 8,830 square foot restaurant on a 2.0 acre site located on the west side
of Paseo Del Norte, north of Palomar Airport Road and south of Car Country
Drive in the Coastal Zone and Local Facilities Management Zone 3.
I. RECOMMENDATION
That the Planning Commission ADOPT Planning Commission Resolutions No. 5100, 5101, and
5102 RECOMMENDING ADOPTION of a Negative Declaration and RECOMMENDING
APPROVAL OF CUP 01-06 and CDP 01-18 and ADOPT Planning Commission Resolution
No. 5103, APPROVING SDP 80-ll(D), based on the findings and subject to the conditions
contained therein.
II. INTRODUCTION
These applications propose developing an 8,830 square foot restaurant and to amend the site
development plan of the Holiday Inn (Andersen's) site located on Paseo Del Norte, north of
Palomar Airport Road. The proposed restaurant land use is permitted by the Commercial -
Tourist Zone, Qualified Development Overlay Zone (C-T-Q) for the property, subject to the
approval of a Site Development Plan. Because the site is located within the Commercial/Visitor-
Serving Overlay Zone, the Conditional Use Permit process replaces the Site Development Plan
permit. The property is located within the Mello II Segment of the Local Coastal Program
requiring the approval of a Coastal Development Permit. The Site Development Plan
amendment is to reconfigure the existing parking lot for the Holiday Inn. The project is in
compliance with all city requirements.
III. PROJECT DESCRIPTION AND BACKGROUND
The applicant is requesting that the Planning Commission recommend approval of a Conditional
Use Permit and Coastal Development Permit and approve a Site Development Plan Amendment
for the King's Fish House project. The 2.0-acre project site is located adjacent and west of Paseo
Del Norte, north of Palomar Airport Road and south of Car Country Drive. The site is north of,
and adjacent to, Holiday Inn. The project consists of a single-story restaurant totaling 8,830
square feet, including outdoor patios. Parking will be provided at-grade surrounding the building
with 139 parking spaces provided. A covered outdoor dining patio and lounge patio are provided
,,-
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December 19, 2001
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,.
on the street side of the building. A fully enclosed service yard with trash receptacles is located
on the west side of the building, which fronts onto Interstate 5.
A Site Development Plan is required for the revision to the Holiday Inn site. The northerly
property line of the Holiday Inn site is being adjusted south to enable the creation of a parcel for
the new restaurant. As a result, the northerly portion of the existing Holiday Inn parking must be
relocated. The proposed location for the new parking area is an area created by the previous
realignment of Paseo Del Norte. Paseo Del Norte used to swing to the west just past the Holiday
Inn to almost touch the I-5 right-of-way. The road was realigned to the east, at its present
location, which left a triangular parcel of land in front of the Holiday Inn. The new parking
configuration will take advantage of this area. There is a net increase of four parking spaces for
the Holiday Inn site from 421 to 425. The new parking area will maintain the existing 20-foot
parking landscape setback.
Access to the site is via a new driveway off Paseo Del Norte. An access drive is also proposed to
interconnect the site with Holiday Inn. Two future access points are provided on the north side
of the project to provide future access to the adjacent vacant site. The existing improved cul-de-
sac bulb off Paseo Del Norte will be vacated and removed.
The building is "vintage Americana" to reflect the look of old fisheries with red brick and
wrought iron exterior finishes. The design incorporates brick and metal cornices, faux brick
arched windows with wood shutters, and faux copper downspouts. On the front of the building
is an outdoor dining patio. The patio area is covered with a standing seam metal roof painted
black supported by decorative metal columns with decorative metal brackets. A decorative metal
fence encloses the patio. The east elevation (Holiday Inn) uses a brick veneer and stucco finish.
The standing seam roof on this elevation is silver colored. The entry is wood paneled with wood
molding.
The project site is relatively flat and does not have any physical or environmental constraints. A
portion of the site has been previously developed as the original alignment of Paseo Del Norte
and then as extra parking for Anderson's and a public street, which is to be removed. The
project incorporates a storm water detention basin in the northwest comer to address water
quality concerns. The finish floor elevation of the building is proposed at 68 feet above mean sea
level (MSL). The elevation of the freeway adjacent is 55 feet MSL. The proposed grading for
the site is balanced with no import or export of soil material.
The following table lists the general plan, zoning and existing land use for the site and adjacent
properties:
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General Plan, Zonin11 & Existin11 Land Use for the Site and Adiacent Pronertv
GENERAL PLAN ZONING EXISTING LAND
USE
Site Travel/Recreation (T-Commercial-Tourist -Partially developed as
R) Qualified Overlay (C-parking lot/Vacant
T-Q)/
CommerciaWisitor-
Serving Overlav
North T-R C-T-Q/ Vacant
CommercialNisitor-
Serving Overlay
South T-R C-T-Q/ Hotel/Restaurant/Gas
Commercia!Nisitor-station
Serving Overlav
East Regional Commercial General Commercial Commercial
-Qualified Overlay/
CommerciaWisitor-
Serving Overlav
West Transportation Transportation Freeway
Corridor Corridor
Applicable Regulations
The proposed project is subject to the following plans, ordinances and standards as analyzed
within the following section of this staff report:
A. Travel/Recreation (T-R) General Plan Land Use Designation;
B. Commercial-Tourist, Qualified Development Overlay Zone (C-T-Q);
C. Conditional Use Permit findings and findings pursuant to the CommerciaWisitor-
Serving Overlay, Chapter 21.208.110;
D. Comprehensive Land Use Plan for McClellan-Palomar Airport;
E. Mello II Segment of the Local Coastal Program, the Coastal Agricultural Overlay Zone -
Carlsbad Municipal Code, Chapter 21.202 and the Coastal Resource Protection Overlay
Zone -Carlsbad Municipal Code, Chapter 21.203; and
F. Growth Management Ordinance (Local Facilities Management Plan Zone 3).
IV. ANALYSIS
The recommendation of approval for this project was developed by analyzing the project's
consistency with the applicable policies and regulations listed above. Therefore, this section will
cover the project's compliance with each of the regulations listed above in the order in which
they are presented.
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A. General Plan
The General Plan designation for the project site is Travel/Recreation (T-R). The project
complies with all elements of the General Plan as illustrated in the table below:
GENERAL PLAN COMPLIANCE
ELEMENT USE, PROPOSED USES & COMPLY?
CLASSIFICATION, IMPROVEMENTS
GOAL, OBJECTIVE
ORPROGRAM
Land Use Development area is Restaurant use Yes
desi"" ated as T -R orooosed
Circulation New development Roadway Yes
shall dedicate and improvements in the
improve all public form of curb, gutter,
right-of-way for sidewalk, and
circulation facilities streetlights exist.
needed to serve
develooment
Noise Utilize noise The project is a Yes
standards contained in compatible use within
the Comprehensive the 60-65 CNEL with
Land Use Plan for no mitigation required
Palomar Airport for indoor/outdoor
uses.
Open Space & To contro I storm Provide a detention Yes
Conservation water pollutants. basin for water quality
management.
The project also includes the vacation of the existing cul-de-sac street located at the northern end
of the hotel site, which is referred to as Andersen Way. The cul-de-sac is approximately 900 feet
long and currently provides access to the Holiday Inn parking lot. The removal of the cul-de-sac
will not preclude access to any other properties. Adequate vehicular circulation will be provided
in the redesign of the Holiday Inn parking area as a loop drive. Additional access will be
available through the Fish House parking lot via a private reciprocal access and parking
agreement.
B. C-T-Q and CommerciaWisitor-Serving Overlay Zoning Regulations
The development area of the project site is zoned Commercial-Tourist, Qualified Development
Overlay Zone (C-T-Q). The project site is also located within the Commercia!Nisitor-Serving
(CVS) Overlay Zone. The CVS Overlay zone contains the development standards for projects
within the overlay and supercedes those of the underlying zone. In addition, the requirement to
process a Site Development Plan is superceded because of the Qualified Development Overlay
Zone. The Conditional Use Permit findings and the CVS findings are discussed further in this
report.
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The project complies with all requirements of the C-T and CVS Overlay Zone as demonstrated in
the following table:
C-T ZONE I CVS OVERLAY COMPLIANCE
STANDARD REQUIRED PROPOSED
Permitted Use Commercial/Visitor-Serving Restaurant
use (i.e. Restaurant)
Parking 139 spaces 139 soaces
Signs 101 sq. ft. 101 sq. ft.
Complement overall building Proposed signs complement
sn,le building
Building Height 35 ft. / 45 ft. for allowed 25 ft.
protrusions
Roof top equipment/ structural Roof mounted equipment
features screened screened from view by
oaraoets
Setbacks Front -30 feet/ 20 landscaped 89.5 ft./ 22.5 ft. landscaped
Interior Side Yard -10 ft./ 10 81 ft. / 10 ft. -landscaped
ft. landscaped
Rear Yard -30 ft./ 10 ft. 57 ft./ 12.5 ft. landscaped
landscaped
Decorative oaving entrv 900 sq ft minimum 1170 sa. ft.
Monument sign landscaping One palm/six birds of Landscaping complies with
oaradise/agapanthus CVS Overlav
Landscaping 1 tree /six parking spaces (23 35 provided (1/ four parking
required) spaces)
15 gal minimum 15 gal to 48 inch box
Screening of parking area. Landscape berm and screen
Screened loading, trash, and hedge. Enclosed loading,
deliverv areas. deliverv and trash area.
The CVS Overlay allows two primary architectural styles. One is the Village Architectural style
and the other is the Contemporary Southwest Architectural style. An alternative architectural
style may be proposed which is what the King's Fish House has done. The alternative
architectural style may accommodate a reasonable version of the user's corporate architectural
style, provided that the elements do not dominate the building design so as to create
incompatibility in the area. Although the design incorporates the corporate architecture, the
building does not have significant features that would cause it to stand out or be incompatible
with the surrounding buildings. The architecture, as described earlier, is "vintage Americana."
The building is rectangular in shape with a brick veneer, with architectural features and
enhancements, and a standing seam metal dining patio cover. The materials used, such as brick
and wood, are high quality materials that enhance the building image. The dark red brick, black
r
CUP 01-06/CDP 01-18/SD'f:-'S0-1 l(D)-KING'S FISH HOUSE
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metal canopy, and accent colors are appropriate for the building materials and building style.
Pursuant to the CVS overlay, the applicant had submitted a preliminary review to review the site
design and alternative architectural design. The project was reviewed and supported by the City
Council and the enforcement official (Community Development Director) at the conclusion of
the pre-filing process.
C. Conditional Use Permit findings and findings pursuant to the Commercial/Visitor-
Serving Overlay
Commercial projects located within the Commercial/Visitor Serving Overlay Zone require
approval of a conditional use permit by the City Council. The four findings for conditional use
permit and the required findings for the CVS Overlay Zone are summarized in this section.
I. That the requested use is necessary or desirable for the development of the community,
is essentially in harmony with the various elements and objectives of the General Plan,
and is not detrimental to existing uses specifically permitted in the zone in which the
proposed use is located.
The proposed restaurant is a permitted use in the C-T zone and CVS Overlay and will
provide a service for the residential, tourist and business communities. The proposed
restaurant is not detrimental to the existing commercial and hotel uses in that it provides the
required on-site parking and has adequate traffic circulation. The project incorporates the
required development standards of the Commercial/Visitor Serving Overlay Zone to ensure
compatibility of the project with the community.
2. That the site for the intended use is adequate in size and shape to accommodate the use.
The 2.0 acre site is adequate in size and shape to accommodate the proposed use in that the
restaurant can fit within the proposed development area without the need for any
development standard modifications.
3. That all the yards, setbacks, walls, fences, landscaping, and other features necessary to
adjust the requested use to existing or permitted future uses in the neighborhood will be
provided and maintained.
The project complies with all of the development standards and parking requirements of the
C-T zone and CVS Overlay Zone. Adequate building and landscape setbacks have been
provided. The project incorporates a service yard to enclose the restaurant service area, trash
enclosures, and storage. The building design is such that any roof-mounted mechanical
equipment is screened from view. Future access points to the adjacent property have been
made to facilitate development of that property.
4. That the street system serving the proposed use is adequate to properly handle all
traffic generated by the proposed use.
A traffic study was submitted for the development proposal, which indicates that the
restaurant would generate approximately 902 Average Daily Trips (ADT). The proposed
project will add a minimal amount of traffic to this location in the PM peak hour (96 ADT).
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The increase in vehicle trips has been analyzed and based on City traffic studies and the
proposed Palomar Airport Corridor Improvements, the Engineering Department has found
that the proposed use will not reduce the level of service of the surrounding roadways and
key intersections to an unacceptable level and that the existing street system is adequate to
properly handle the 902 ADT generated by the development proposal.
The Commercia!Nisitor Serving Overlay Zone requires three additional findings as follows:
5. That the proposed project is adequately designed to accommodate the high percentage
of visitor, tourist, and shuttle bus/alternative transportation users anticipated given the
proposed use and site location within the overlay zone.
The on-site circulation system has been adequately designed to accommodate the flow of
traffic without creating conflicts between uses. The project provides the required number of
parking spaces to accommodate the use. The project will also enter into a private reciprocal
access and parking agreement with the adjacent uses to the north and south. A separate
pedestrian walk has been provided from the public right-of-way to the restaurant.
6. That the building form, building colors and building materials combine to provide an
architectural style of development that will add to the objective of high quality
architecture and building design within the overlay zone.
The building has been designed with an alternative architectural design, which will be
compatible with the other surrounding buildings. The building design, materials and colors
proposed represent a high quality of architectural design through the use of architectural
details and building forms which are complementary to the surrounding buildings in the
vicinity.
7. That the project complies with all development and design criteria of the overlay zone.
As outlined previously in the zoning compliance table above, the project meets or exceeds all
of the development and design criteria of the overlay zone including, but not limited to
parking, signage, building height, building setbacks, building design, and landscaping.
D. Site Development Plan Amendment
The amendment to reconfigure the parking area of the Holiday Inn (Andersen's) is not subject to
the CVS Overlay as it is an existing development being modified as follows; does not change
any of the existing of uses; does not invoke a higher parking standard; or change the square
footage of any building. The proposal is consistent with existing uses allowed by the original
site development plan. The revision relocates and adds four parking spaces. The parking ratios
applied to the existing uses would require 366 parking spaces. The parking provided, after
modification, is 425 parking spaces, which is 59 spaces over the required amount.
The parking lot redesign provides adequate traffic circulation as it still provides through
circulation around the hotel site. Through access is provided to the restaurant site, which is
similar to the previous traffic circulation pattern. The new parking lot design incorporates ten-
foot landscaped setbacks to match the existing and adjacent parking areas. The balance of
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parking demand is not disrupted since the parking area being relocated is remote and not
frequently used.
E. Comprehensive Land Use Plan for McClellan -Palomar Airport
The project site is located approximately two miles west of the airport and within the Airport
Influence Area for McClellan -Palomar Airport. The site is inside the 60 Community Noise
Equivalent Level (CNEL) noise contour. The airport land use plan identifies the restaurant use
as being compatible within the 60 CNEL. The project was sent to the Airport Manager in
addition to SANDAG staff. The project is in conformance with the airport land use plan.
F. Mello II Segment of the Local Coastal Program
As designed, the project is consistent with the relevant policies of the Mello II Segment of the
Local Coastal Program (LCP). The restaurant is an appropriate use with the LCP land use
designation of Travel Service. The site is currently partially developed as a parking lot and
graded area. No environmentally sensitive habitats exist on or adjacent to the site. Because the
proposal includes grading, the provisions contained in the Mello II land use policies prohibiting
grading during the winter months (October 1st -April 1st) are included as conditions of approval.
Since the project is located one half mile from the ocean, no shoreline development regulations
apply. No scenic resources exist on or near the site. The project does not impact any non-prime
coastal agricultural land. Therefore, the proposed restaurant is consistent with the Mello II land
use policies and the applicable implementing ordinances.
G. Growth Management Ordinance (LFMP Zone 5)
The proposed project is located within Local Facilities Management Zone 3 in the northwest
quadrant. The impacts on public facilities created by this project and compliance with the
adopted performance standards are summarized as follows:
FACILITY IMPACTS COMPLIANCE WITH
STANDARDS
City Administration NIA Yes
Librarv NIA Yes
Wastewater Treatment 4.9EDU Yes
Caoacitv
Parks NIA Yes
Draina11:e Basin B Yes
Circulation 902ADT Yes
Fire Station 4 Yes
()pen Space NIA Yes
Schools Payment of non-residential Yes
school fee at bldg. permit
1Ssuance
Sewer Collection Svstem 4.9EDU Yes
Water Distribution Svstem I 078 Gallonsldv Yes
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V. ENVIRONMENTAL REVIEW
The proposed project has been reviewed pursuant to the California Environmental Quality Act
(CEQA). Staff prepared an initial study for the project and concluded that no potentially
significant impacts would result with the implementation of the project. The project is within
the scope of the City's Master Environmental Impact Report (MEIR) which was utilized to
address the project's cumulative air quality and circulation impacts. A MEIR may not be used
to review projects if it was certified more than five years prior to the filing of an application for
a later project. The City is currently reviewing the 1994 MEIR to determine whether it is still
adequate to _review subsequent projects. Although the MEIR was certified more than five years
ago, the City's preliminary review of its adequacy finds that no substantial changes have
occurred with respect to the circumstances under which the MEIR was certified. The only
potential changed circumstance, the intersection failure at Palomar Airport Rd. and El Camino
Real has been mitigated to below a level of significance with new roadway improvements.
Additionally, there is no new available information, which was not known and could not have
been known at the time the MEIR was certified. Therefore, the MEIR remains adequate to
review later projects. In consideration of the foregoing, on July 24, 2001 the Planning Director
issued a Negative Declaration for the proposed project.
ATTACHMENTS:
1. Planning Commission Resolution No. 5100 (Neg. Dec)
2. Planning Commission Resolution No. 5101 (CUP)
3. Planning Commission Resolution No. 5102 (CDP)
4. Planning Commission Resolution No. 5103 (SDP)
5. Location Map
6. Background Data Sheet
7. Local Facilities Impact Assessment Form
8. Disclosure Statements
9. Planning Commission Resolution No. 1964, dated May 26, 1982
10. Planning Commission Resolution No. 2351, dated September 26, 1984
11. Planning Commission Resolution No. 3463, dated November 18, 1992
12. Reduced Exhibits
13. Full Size Exhibits "A" -"M", dated December 19, 2001
VL:cs:mh
-
PALOMAR AIRPORT RO
KING'S FISH HOUSE
CUP 01-06/CDP 01-18/SDP 80-11(0)
" BACKGROUND DATA SHEET
CASE NO: CUP 01-06 / CDP 01-18 / SDP 80-ll(D)
CASE NAME: KING'S FISH HOUSE
APPLICANT: KING'S SEAFOOD COMPANY
--
REQUEST AND LOCATION: An 8,830 square foot restaurant located on the west side of
Paseo Del Norte, north of Palomar Airport Road and south of Car Country Drive
LEGAL DESCRIPTION: a portion of Parcel 2 of parcel map no. 11284, in the City of
Carlsbad, County of San Diego, State of California, according to map thereof, filed in the Office
of the County Recorder of San Diego County, May 11, 1981 and a portion of Parcel 4 of
Carlsbad Tract No 92-07, in the City of Carlsbad, County of San Diego, State of California,
according to map thereof no. 13078, filed in the Office of the County Recorder of San Diego
County, December 28, 1993
APN: 211-021-04 and-23 Acres: 2.0 Proposed No. of Lots/Units: .,_1 ________ _
GENERAL PLAN AND ZONING
Land Use Designation: Travel-Recreation Commercial (T-R)
Density Allowed: n/=a'--------Density Proposed: ,.,n/'-"a'-------------
Existing Zone: Commercial-Tourist-Qualified Development Overlay Zone and
Commercial Visitor/Serving Overlay Zone Proposed Zone: n"'o"-"'ch,.,,a,,,n.,.g,=e'----------
Surrounding Zoning, General Plan and Land Use:
Site
North
South
East
West
Zoning
C-T-Q
C-T-Q
C-T-Q
C-2-Q
Transportation Corridor
General Plan
T-R
T-R
T-R
Regional commercial
Transportation Corridor
PUBLIC FACILITIES
Current Land Use
Parking/Vacant
Vacant
Hotel/Commercial
Commercial
Interstate 5
School District: Carlsbad Water District: Carlsbad Sewer District: Carlsbad
Equivalent Dwelling Units (Sewer Capacity): _,_4"'.9:..,EeeD=U'----------------
ENVIRONMENTAL IMPACT ASSESSMENT
~ Negative Declaration, issued J,_,u"'lJ..y_,,2c,:4~, 2..,0,,,0,,lc__ _______________ _
D Certified Environmental Impact Report, dated ______________ _
D Other, ____________________________ _
CITY OF CARLSBAD
GROWTH MANAGEMENT PROGRAM
LOCAL FACILITIES IMPACTS ASSESSMENT FORM
PROJECT IDENTITY AND IMPACT ASSESSMENT:
FILE NAME AND NO: KING'S FISH HOUSE CUP 01-06 / CDP 01-18 / SDP 80-ll(D}
LOCAL FACILITY MANAGEMENT ZONE: .l GENERAL PLAN: Travel/Recreation
Commercial
ZONING: Commercial Tourist -Qualified Overlaxf Commercial Visitor/Serving Overlay
DEVELOPER'S NAME: King's Seafood Company
ADDRESS: 100 W. Broadway, #550, Long Beach, CA 90802
PHONE NO.: {562) -437-8824 ASSESSOR'S PARCEL NO.: 211-021-04/23
QUANTITY OF LAND USE/DEVELOPMENT (AC., SQ. FT., DU): 8,830 Sq Ft
ESTIMATED COMPLETION DATE: ASAP
A. City Administrative Facilities: Demand in Square Footage = NIA
B. Library: Demand in Square Footage = NIA
C. Wastewater Treatment Capacity (Calculate with J. Sewer) 4.9EDU
D. Park: Demand in Acreage = NIA
E. Drainage: Demand in CFS = 12.2
Identify Drainage Basin = B
F. Circulation: Demand in ADT = 902
G. Fire: Served by Fire Station No. = 4
H. Open Space: Acreage Provided = NIA
I. Schools: Carlsbad NIA
J. Sewer: Demands in EDU 4.9
K. Water: Demand in GPD = 1078
L. The project does not impact the Growth Management Dwelling unit allowance.
CCity of c...,-Jarlsbad
I A 61,1,11,i· I •14 -,~,; i, ,14 ,SI
DISCLOSURE ST A TEME:\'T
Applicant's statement or disclosure of certam ownership interests on all apphcauons which will require j
discretionary action on the pan of the City Council or any appointed Board. Commission or Commmee. i
The following information MUST be disclosed at the time of applicauon submma!. Your project cannot
be reviewed until this information is completed. Please print.
Note:
Person is defined as "Any individual, finn, co-partnership, joint venture, association, social club. fraternal
organization, corporation, estate, ttust, receiver, syndicate, in this and any other county. city and county, city
municipality, district or other political subdivision or any other group or combination acnng as a unit."
Agents may sign this document; however, the legal name and entity of the applicant and property owner must be
provided below.
I. APPLICANT (Not the applicant's agent)
2.
Provide the COMPLETE, LEGAL names and addresses of ALL persons having a financial
interest in the application. If the applicant includes a corporation or partnership. include the
names, title, addresses of all individuals owning more than I 0% of the shares. IF NO
INDIVIDUALS OWN MORE THAN 10% OF IBE SHARES, PLEASE INDICATE NON-
APPLICABLE (NIA) IN THE SPACE BELOW If a publicly-owned corporation, include the
. names, titles, and addresses of the corporate officers. (A separate page may be attached if
necessary.)
Person Corp/Pan ,,,A:=,---G...i -..,;e-=-=,.,.., Cc:l,
Title:..::;:::!:;:~::::;~~-6~:!.!::::~~~ Title_· _____________ _
Address / a:::> Address, ______________ _
OWNER (Not 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 partnershjp. 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 (NIA) IN THE SPACE BELOW. If a publicly-
owned corporatjon, include the names, titles, and addresses of the corporate officers. (A separate
page may be a ched if necessary.)
~ Title._=+----.,,C..-----::.1--
•~i=.t........j:;..j~~'.!.:.:.~t
1635 Faraday Avenue• Carlsbad, CA 92008-7314 • (760) 602-4600 • FAX (760) 602-8559 @
3.
"'I-4.
NON-PROFIT CAJll"IZA TION OR TRl'ST
If any person identified pursuant to (I) or (2) above 1s a nonprofit orgamzat1on or a rrus:. i,,: t:i,·
names and addresses of AID: person serving as an officer or director of the non-pro1-,:
organization or as trustee or beneficiary of the.
Non Profit/Trust ________ _ Non ProfitTrust __________ _
Title. ___________ _ Title. _____________ _
Address, __________ _ Address, ____________ _
Have you had more than $250 worth of business transacted with any member of Cny staff.
Boards, Commissions, Committees and/or Council within the past rwelve (:12) months0
D 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.
' \,( \\\cv:Ji\ \n6~3t;C·~
Print or type name of owner Print or type name of applicant
~ . ~t--) . -. ✓ ~C:9(~~ 1L \\\~ iv!:( ,~~
Print or type name of owner/applicant's agent
H:ADMIN\COUNTER\DISCLOSURE STATEMENT 5198 Page 2 of 2
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