HomeMy WebLinkAboutCD 12-17; NEW PARKING TOLL BOOTHS; Consistency Determination (CD),. . ,. -
CITY OF CARLSBAD APPLICATION FORM FOR CONSISTENCY DETERMINATION APPLICATION
PROJECT NAME: ~(Jl.AN{) C&1e. n t.t-56t>Ttt ttrftrAk.JAJ(:!J ~trf
Assessor's Parcel Number(s): ;,_.[ / _ { (J (J -tJ ' ,
Description of proposal (add attachment if necessary): JfEJ//Sf: flnfl/t:.& '~ 7l!' J'~
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Would you like to orally present your proposal to your assigned staff planner/engineer? Yes D No
Please list the staff members you have previously spoken to regarding this project. If none, please so state.
OWNER NAME (Print): ~Rillf (l r tfQIAJIN~
MAILING ADDRESS: I 1.,Eh4Lirt~P IJI(
CITY, STATE, ZIP: C!..lrz..cA!rp fLr ,2-J?~Y
TELEPHONEo '7"0-i(~~,
EMAIL ADDRESS: s-~-,;:: L 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
ABO E INFO ATION IS TRUE AND CORRECT TO THE BEST OF
MY WL E.
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SIG ATE
MAILING ADDRESS:
CITY, STATE, ZIP:
SIGNATURE
APPLICANT'S REPRESENTATIVE (Print):
MAILING ADDRESS: ~b)bE ~
CITY, STATE, ZIP:
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TELEPHONE
------~~~~~-------
DATE
TIVE OF THE
ION IS TRUE
GE.
EMAIL ADDRESS: C.tf"i lAD 'tte'?,. . R d M Q(~ 7! L 6b D l.A N() • C4 (L
I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE
APPL ANT AN HAT ALL THE ABOVE INFORMATION IS TRUE AND
COR E T TO BEST OF MY KNOWLEDGE.
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SIG DATE
IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE NECESSARY FOR MEMBERS OF CITY STAFF TO INSPECT AND
E •R TH PROP RTY THA THE BJECT F THIS APPLICATION. IM/E CONSENT TO ENTRY FOR THIS PURPOSE.
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P-16 Page 2 of 2 Revised 07/10