HomeMy WebLinkAboutCD 2017-0004; GOLDEN SURF; Tentative Map (CT)-
CITY OF CARLSBAD APPLICATION FORM FOR CONSISTENCY DETERMINATION APPLICATION
CITY USE ONLY ,
Original Project Number: (; (~ -Consistency Determination Number: C,o'l-011 ,,.. ODO+
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Would you like to orally present your proposal to your assigned staff planner/engineer? Yes D
D
No
Please list the staff members you have previously spoken to regarding this project. If none, please so state.
,J; S:::O(l .G"off-_ P/Mni'!I,__ S'/eve /?c£6ct-f -£;,9 i11ee/'i~
OWNER NAME (Print):
MAILING ADDRESS:
CITY, STATE, ZIP:
TELEPHONE:
EMAIL ADDRESS:
ltXO Co...cti, M p,,.,, fAs /JaM
Q,..r-,rta.d J al :12 o II
760-~St?-9962. .
•owner's signature Indicates pennisslon 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. 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
KNOW:;E. ~ ·;.~ ~ ~ L=/1 -zt-,,11r1,
SIGNAI.J .,c:» DATE
APPLICANT NAME (Print)A/ew Po1,1k UJ«ltnlAOlt:te~
MAILING ADDRESS:Jt,EFO UJ. Ber(lc,J'Clp Dr. 5"k. "l
CITY, STATE, ZIP: .X,Q Die'(?() 1 cA 9'Z..(2.7
' TELEPHONE: (<JrS"(.} ?::Pt' ,.l{ l{S-/-rf1DO
EMAIL ADDRESS: +f St:Arid.Sl/h/'1. @()eUJ(?;ltlffecleve
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.
2[Zft/17
DATE
APPLICANTS REPRESENTATIVE (Print): _...;.-J",....,.y....,/..,.C,""'r __ s:;~,..,o ... c;J,._S:::..._..i_._,._.0..._(n~--------------
MAILING ADDRESS: JCS:YQ LU, Bcrt"lo.cc) o Or-S-1--e.. 2,3v
c1TY. STATE. z1P: Ic/\a o,e9t), cl1 921z. 7
i TELEPHONE: .P..s-? . l/st-' r JW ~c;-4 -qq 11
. EMAIL ADDRESS: f-j So. nd., 5""-/·ro fl/\ @ 17 e(J po 1 nfe d (:Ve /op , CO n,,,
I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE APPLICANT AND THAT ALL THE ABOVE INFORMATION IS TRUE AND I COR~ECT TO THE BEST OF MY KNOWLEDGE.
1 srcffii~ DJ/"2 V/!7 RECEIVED
FEE REQUIRED/DATE FEE PAID: MA
RECEIVED BY: r'1TY '·· ' . C.J\r{LSBAD
P-16 Page2 of2 Revised 08/16
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BILLING CONTACT
TYLER SANDSTROM
NEW POINTE COMMUNITIES INC
INVOICE NUMBER INVOICE DATE
00004672 03/03/2017
REFERENCE NUMBER FEE NAME
• • ·~ ~ ... -
1NV01 CE (00004672)
INVOICE DUE DATE
03/03/2017
City of Carlsbad
1635 Faraday Avenue
Carlsbad, CA 92008-7314
INVOICE STATUS
Due
CCityof
Carlsbad
INVOICE DESCRIPTION
NONE
TOTAL
CD2017-0004 CONSISTENCY DETERMINATION (PLN) $733.00
6798 Paseo Del Norte Carlsbad, CA 92009 SUB TOTAL $733.00
TOTAL~'~~~~~~-$7_3_3_.o_o~
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March 03, 2017 11 :49 am Page 1 of 1
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