HomeMy WebLinkAboutCD 13-09; WALGREENS AT LA COSTA TOWN SQUARE; Consistency Determination (CD)CITY OF CARLSBAD APPLICATION FORM FOR CONSISTENCY DETERMINAnON APPLICATION
CITY USE ONLY CVl3-D~ Project Number:
PROJECT NAME: w~i9ftMS g.:l: ldA f.()Sm 'Tgw\1\ S%u~r-e
Assessor's Parcel Number(s): ').1-?, .... 0\.oO .. 31....
Description of proposal (add attachment If necessary): ~Vi:f,\,\J cf +\1\-t ~!OOQS-0 0\A~~~H:\~
f.\t.\LciliOY\5 £or wal~:cert.s 1n tif~YMlV\f Ul~~\~teJ'\C~ wl-\11\ ~ppv(lvtd
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Would you like to orally present your proposal to your assigned staff planner/engineer? Yes 0 No [i;r'
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): 0apt~ \)r~t,l{l~fr\t (cQttYS APPLICANT NAME (Print): W4 igrf"'C.Y\ ( Jl
MAILINGADDRESS: ~~~a ~;\zrntV\'~t fna,ll Q.ogt'J\ MAILING ADDRESS: iO~ iJJIIO:W \-l2.!A. ~ B.{UJ
CITY, STATE, ZIP: \'\-t~Stlrltllh I (.~ 9~S"J]( CITY, STATE, ZIP: ute.rn e.~d , -c. 1... ~~ca12
TELEPHONE: Q1~-~:a~-l~t5 TELEPHONE: $!:i'l· Q\S-4~1..~
EMAIL ADDRESS: j\Aab . flnl~9 s Pdc;t.nftK I (QM EMAIL ADDRESS: :;i~c. 'ffil:~~VIS.\Ul > 6}
*OWner's slgnatuhl Indicates pennlaalon to conduct a preliminary WO..\':)"Ct~ . .'V'\S., (A'VV'\
review for a development proposal.
I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE
ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE
MY KNOWLEDGE. tiro
1
CORREV TO ~E BEST OF MY KNOWLEDGE.
DL'-l'*'l>l . \ IV'<\~Vt. 07/30/13
SIGNATURE DATE SI~NATURE ~ '-\' DATE
APPLICANrS REPRESENTATIVE {Print): ~ v ,~,~ e e..n f}t.v Get
MAILING ADDRESS: k~O ~-(.:LtMt\)Jru· ~ ~1--HQ
CITY, STATE, ZIP: DhaC: tli ~ 1 e~ S{S:01~ REe!IVED TELEPHONE: LD01-· (0 5{-ft\\1 00 • EMAIL ADDRESS: ¥rQlAMS 8 t~~'(t, ~vn JUL 3 l 2013
I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE CITY OF CARLSBAD
APPliCANT AND THAT ALL THE ABOVE INFORMATION IS TRUE AND PLANNING DIVISION CORRECT TO THE BEST OF MY KNOWLEDGE. tQ~ '7{ '2.PI ' 13 SIGTURE -_) DATE
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. WIE CONSENT TO ENTRY FOR THIS PURPOSE.
PROPERTY OWNER SIGNATURE
FEE REQUIRED/DATE FEE PAID: flta~ -1/3 aj, 3
RECEIVED BY: 6~ l 7
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P-16 Page 2of2 Revised 07/10