HomeMy WebLinkAboutCD 2017-0008; TWIN D RECYCLED WATER PUMP; Consistency Determination (CD)CITY OF CARLSBAD APPLICATION FORM FOR CONSISTENCY DETERMINATION APPLICATION
CITY USE ONLY
Original Project Number: Ct)Z,O) .,. Ot>l!>f> Consistency Determination Number:
PROJECT NAME: McCLELLAN-PALOMAR AIRPORT NOISE MONITOR POLE
Assessor's Parcel Number(s): ~/ ~ -0~ f -{ C:,--c:><) r
Description of proposal (add attachment if necessary): INSTALLATION OF 19' POLE WITH NOISE MONITORING SENSOR
MOUNTED ON TOP TO EVALUATE NOISE LEVELS FROM AIRPORT ACTIVITY. PROJECT COMPLIES WITH ALL THE GUIDELINES AS
AS STATED IN POLICY NO. 35 FOR DESCRETIONARY PERMIT CONSISTENCY DETERMINATIONS
Would you like to orally present your proposal to your assigned staff planner/engineer? Yes ~ No
D
Please list the staff members you have previously spoken to regarding this project. If none, please so state.
JASON GELDERT, P.E. -CITY ENGINEER
OWNER NAME (Print): CARLSBAD MUNICIPAL WATER DISTRICT APPLICANT NAME (Prin...:t),,....: ~~:..!i~=:......J~~l...fl!:;e'1:a::.-i~~~
5950 EL CAMINO REAL MAILING ADDRESS:.-2?~,l ~~o~.<,M~~M&LL--4'Zi:.:::f._ MAILING ADDRESS:
CITY, STATE, ZIP:
TELEPHONE:
CARLSBAD, CA 92008 CITY, STATE, ZIP: A (;~t, t?-*7, t?4 Mil'
760438-2722 TELEPHONE: GJ'f .,!)J'?-,l(,?/:
EMAIL ADDRESS:
*Owner's signature indicates pennission 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
INFOR TION IS UE AND CORRECT TO THE BEST OF MY
KNOW DG
1>/2'1/lJ-
DATE
EMAIL ADDRESS: ~,ttllt<,l €,,Mt'c4fJWDfl 11c Z,y,(;
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.
///_
~
APPLICANT'S REPRESENTATIVE (Print): ,.,,,. 312.D __::.__:_.:~-"--...:::::1IP!-'=::....L-..1r:::...=------------------
MAILINGADDRESS: ~ Al-::tv?a«:-<1/dv~
CITY,STATE,ZIP: _s:;;,o\) l'.J1~4co , (14 9-1//,3
;,
TELEPHONE: ;ft~ z~~ EMAIL ADDRESS:
HAT I AM THE LEGAL REPRESENTATIVE OF THE APPLICANT AND THAT ALL THE ABOVE INFORMATION IS TRUE AND
TOT OF MY KNOWLEDGE~
/7
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FEE REQUIRED/DATE FEE PAID: •133/ t.f-ll-t:7
RECEIVED BY: -~~---------------~A~PR~O ~6~2_01_7 ___ _
c ; r ( , ·:_, __ ::~/1,D
P-16 Page 2 of 2 Revised 08/16