HomeMy WebLinkAboutCD 2016-0003; ACUSHNET MEZZANINE ADDITION; Administrative Permits (ADMIN)•7)a)4
CITY OF CARLSBAD APPUCATION FORM FOR CONSISTENCY DETERMINATION APPLICATION
larrAisEoLY
.*
prisitAm4thir I.F 1 ,9011001.110.Dlitenall1118°04Mben CD 20 -0003 ,
PROJECT NAME:Acushnet Mezzanine Addition
Assessor's Parcel Number(s):209-083-16
Description of proposal (add attachment If necessary):See attachect,
•
Yes 0Would you like to orally present your proposal to your assigned staff planner/engineer?No
Please list the staff members you have previously spoken to regarding this project.If none, please so state.
Don Neu
Josh Gravennr. flirector of Investment Manaeement
OWNER NAME (Print):HG REIT II 2819 Loker LP APPLICANT NAME (Print):Carla Alexander
MAIUNG ADDRESS:4747 Executive Drive,Suite 410 MAILING ADDRESS:4747 Executive Drive, #410
CITY, STATE, ZIP:San Diego,CA 92121 CITY, STATE, ZIP:San Diego, CA 92121
TELEPHONE:858.435.4000 TELEPHONE:858.4354000
EMAIL ADDRESS:Carla.Alexander@hines.com EMAIL ADDRESS:Carla.Alexander@hines.com
*Owner's signature Indicates permission to conduct a preliminary
review fora development proposal.
IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE
NECESSARY FOR MEMBERS OF CITY STAFF TO INSPECT AND OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE
ENTER THE PROPERTY THAT IS THE SUBJECT OF THIS AND CORRECT TO THE BEST OF MY KNOWLEDGE.
APPLICATION.I/WE 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 MY DocuSigned by:
KN •11/17/2016
11/17 fibi F54AA702§77C4FF
SIGNATURE DATE SIGNATURE DATE
APPLICANTS REPRESENTATIVE (Print):Patrick Zabrocki -Howes, Weiler and Associates
MAILING ADDRESS:2888 Loker Avenue East #217
CITY, STATE, ZIP:Carlsbad, CA. 92010 •
TELEPHONE:760.929.2288
EMAIL ADDRESS:pzabrocki@hwplanning.com
I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE APPLICANT AND THAT ALL THE ABOVE INFORMATION IS TRUE AND
CORRECT TO THE BEST OF MY KNOWLEDGE.
11/18/16
SIGNATURE DATE
FEE REQUIRED/DATE FEE PAID:-"5 --
RECEIVED BY:jr iviSNRUA
-RECEINL;0
DEC 1.3 2016
CITY (:')CANLSBAD
00f D t PLANNINIC. DIVIS'.311
P-16 Page 2012 Revised 08/16