HomeMy WebLinkAboutCD 2017-0029; KOBAYASHI GUEST HOUSE; Consistency Determination (CD)CITY OF CARLSBAD APPLICATION FORM FOR CONSISTENCY DETERMINATION APPLICATION
CITY USE ONLY Development Number: Il~Ylb0~"'2.
Original Project Number: C,l}f 1 bOL\b Consistency Determination Number: C.D ·'1..0\7 -0071\
PROJECT NAME: /Ln lb~ A-1.lf( {;::,(J~7 /fr,v te-
Assessor's Parcel Number(s): 1--o? lJ-o ft_ ft!,
Description of proposal (add attachment if necessary):
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Would you like to orally present your proposal to your assigned staff planner/engineer? Yes D No
D
Please list the staff members you have previously spoken to regarding this project. If none, please so state.
OWNER NAME (Print): A avioJ (--?obt1 vc, ,c::,\n I APPLICANT NAME (Print): ~'1-\ J.-N a,"~
MAILING ADDRESS: 1,9 ~s Pork.'\), MAILING ADDRESS: ._\> • 0 . Rz t) ){_,-,~ \
CITY, STATE, ZIP: Corl~boc\ q CA cr200 ~ CITY, STATE, ZIP: C Af--'I~ ra~ ,u,f
TELEPHONE: ·1laO 889-\~S-TELEPHONE: 2~0 1l1 v1Z1
EMAIL ADDRESS: 0 -\--\:::oba¥a~~ i (@___h~hYJa1 ( ,con I EMAIL ADDRESS: b C }~V\ ~ D \ Ce_ • \J <
*Owner's signature indicates pennission to conduct a preliminary
review for a 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
SIGNA~•
KNOWLEDGE. kJ)hU-Q__ 9P~ qbolt7 ~.., Zo-l1
SIN~ DATE DTE
APPLICANT'S REPRESENTATIVE (Print):
MAILING ADDRESS: RE -~r::1veo .... (,, ,, C •
CITY, STATE, ZIP: SEe 2 2 20lZ
TELEPHONE: ,;;;1+¥ o-~ C '-'l ~;,L..SB ~D
EMAIL ADDRESS: PLANNING DIVISION
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.
SIGNATURE DATE
FEE REQUIRED/DATE FEE PAID: 21~ {!\--Z.,2-\7
RECEIVED BY: /lfa.dirJ t4
P-16 Page 2 of 2 Revised 07/17