HomeMy WebLinkAboutCD 16-07; COASTLINE COMMUNITY CHURCH; Consistency Determination (CD)CITY OF CARLSBAD APPLICATION FORM FOR CONSISTENCY DETERMINATION APPLICAT ON
CITY USE ONLY
Project Number:
PROJECT NAME: COASTLINE C,ttv {L.Ctf ---------------------------Assessor's Parcel Number(s): 255-273-07-00
Description of proposal (add attachment if necessary):
PARKING LOT EXPANSION
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.
CHRISTER WESTMEN, DAVID RICK
OWNER NAME (Print): COASTLINE C#v(>...L.t"f
MAILING ADDRESS: 511 ENCINITAS BOULEVARD, SUITE 104
CITY, STATE, ZIP: ENCINITAS, CA 92924
TELEPHONE: (760) 438-7500 --------------
EMAIL ADDRESS:
*Owner's signature indicates permission to conduct a preliminary
review for a development proposal.
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. IM/E CONSENT TO ENTRY FOR THIS PURPOSE. I
CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE
ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF
WLEDGE. ~ ~ ( --Y-c..0 -<c.
ATURE DATE
APPLICANT NAME (Print)· SA--M t" /"r5 (:) W N .e_ (L
MAILING ADDRESS: -------------CI TY, 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.
~ ( -~ '/-20-((.
IATURE DATE
APPLICANT'S REPRESENTATIVE (Print): j l ""'-b(LA-t-J'T -~---......_ ____________________ _
MAI LI NG ADDRESS: S-C ';, j A-V"t? I'-,) I O A S N L( IV A-5
c1TY, STATE, z1P: CA-tLLS BA-D ) CA . C,'1..ooj
TELEPHONE: ·7 0 () -'--J "3 S-, -7 S-O b )( -( '2.. 0
EMAILADDRESS: J§ y-o....~+cc) a-y--o....~T@c.· ca~
I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE APPLICANT AND THAT ALL THE ABOVE INFORMATION IS TRUE AND
CT TO THE BEST OF MY KNOWLEDGE.
_____--c-y -),0 -('
DATE
FEE REQUIRED/DATE FEE PAID: ·,
RECEIVED BY, ~ LfuJt1T1,i.,_1_..!...J~---..J..../-C--=-l----l---l¥-----------
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P-16 Page 2 of2 Revised 09/14