HomeMy WebLinkAboutCD 12-11; VIASAT LOT 8; Consistency Determination (CD)CITY OF CARLSBAD APPLICATION FORM FOR CONSISTENCY DETERMINATION APPLICATION
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~roject Number: VV _µ.. -j_j_
, PROJECT NAME: -....,11A<S.4-T l c,r 5
AHesaor'a Parcel Number(■):
Description of proposal (add attachment If neceHary): !21~ £1:QJE::SS-ltJPDLJ. -1.ij
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Would you like to orally present your proposal to your aHlgned staff planner/engineer? Yea No □
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):
. MAILING ADDRESS: CaJS S: 1=; I o0 WJ;\®(l..,.,(
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EMAILADDREss: be'/• ,ri<(Jl;A @ll~c
•Owner's signature Indicates pennl■slon to conduct a preliminary
review for a development proposal.
I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE
ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF LJED~, __ _
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DATE
APPLICANT'S REPRESENTATIVE (Print):
MAILING ADDRESS:
CITY, STATE, ZIP:
TELEPHONE:
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EMAIL ADDRESS: $,, J41ou=F-escA-so, c ot11
I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE
APPLICANT AN THAT ALL THE ABOVE INFORMATION IS TRUE AND
CORRECT Cj, E BEST OF MY KNOWLEDGE.
~ 8 · f (:, · I Z....
SIGNATU E DATE
I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE
OWNER AND TH iT ALL THE ABOVE INFORMATION IS TRUE
AND CORRE iT T THE BEST OF MY KNOWLEDGE.
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SIGNATUR / DATE
RECEIVED
AUG 1 6 2012
CITY OF CARLSBAD
PLANNING DIVISION
IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE NECESSARY FOR MEMBERS OF CITY STAFF TO INSPECT AND
ENTER THE PROPERTY THAT IS THE SUBJECT OF THIS APPLICATION. I/WE CONSENT TO ENTRY FOR THIS PURPOSE.
PROPERTY OWNER SIGNATURE
FEE REQUIRED/DATE FEE PAID: __,,~._./~cw,,.__~.,_,/2'----"8-"'-'lfe::""'-ig'....__ _____________ _
RECEIVED BY:
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