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HomeMy WebLinkAboutCDP 2018-0023; WHITE ADU; Coastal Development Permit (CDP), {cityof Carlsbad LAND USE REVIEW APPLICATION P-1 •·- Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.gov APPLICATIONS APPLIED FOR: (CHECK BOXES) Development Permits (FOR DEPT. USE ONLY) Legislative Permits (FOR DEPT. USE ONLY) ~ Coastal Development Permit D Conditional Use Permit COP 'ic>li,,. 002-?J ~ Minor D General Plan Amendment D Minor D Extension D Day Care (Large) D Environmental Impact Assessment D Habitat Management Permit D Minor D Hillside Development Permit D Minor D Nonconforming Construction Permit D Planned Development Permit D Minor D Residential D Non-Residential D Planning Commission Determination D Reasonable Accommodation D Site Development Plan D Special Use Permit D Minor D Tentative Parcel Map (Minor Subdivision) D Tentative Tract Map (Major Subdivision) D Variance D Minor D Local Coastal Program Amendment D Master Plan D Specific Plan D Zone Change □Amendment □Amendment D Zone Code Amendment South Carlsbad Coastal Review Area Permits D Review Permit D Administrative D Minor D Major Village Review Area Permits D Review Permit D Administrative D Minor D Major NOTE: A PROPOSED PROJECT REQUIRING APPLICATION SUBMITTAL MUST BE SUBMITTED BY APPOINTMENT'. PLEASE CONTACT THE APPOINTMENT SPECIALIST AT (760) 602-2723 TO SCHEDULE AN APPOINTMENT. ASSESSOR PARCEL NO(S): LOCATION OF PROJECT: NAME OF PROJECT: BRIEF DESCRIPTION OF PROJECT: PROJECT VALUE (SITE IMPROVEMENTS) *SAME DAY APPOINTMENTS ARE NOT AVAILABLE '207 -i:~o-lq-eo (STREET ADDRESS) -I, l,~,CUJ-ESTIMATED COMPLETION DATE FOR CITY USE ONLY Development No. 'tif\j' 'Wl1 -0 i'{j: Lead Case No. P-1 Page 1 of 6 Revised 03/17 OWNER NAME INDIVIDUAL NAME {if applicable): COMPANY NAME {if applicable): {PLEASE PRINT) MAILINGADDRESS: 4~o ~J\t.:( Of-r CITY, STATE, ZIP: CAI' LS p._,,::;i) , CA 4'2.Cot> TELEPHONE: 74?,0 .-~s,... erer11 EMAIL ADDRESS: r~\'~ p,A{jt~ ~¼ .. v\it I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I CERTIFY AS LEGAL OWNER THAT THE APPLICANT AS SET FORTH HEREIN IS MY AUTHORIZED REPRESENTATIVE FOR PURPOSES O T APPLICATION. SIGNAT MAILING ADDRESS: CITY, STATE, ZIP: TELEPHONE: EMAIL ADDRESS: APPLICANT NAME INDIVIDUAL NAME {if applicable): COMPANY NAME {if applicable): {PLEASE PRINT) MAILING ADDRESS, ~ Ji "'"'1 ()..;.::;.£.~\I CITY, STATE, ZIP: \ ;-t~ c_p.., t::\'u2:il Cf TELEPHONE: @st, --1 Sf'': ~ '3 ' L, j(;.,,A \ EMAILADDREss: JA:~ "'"'""~ce.,Me'-(d,c ,., 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. IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE NECESSARY FOR MEMBERS OF CITY STAFF, PLANNING COMMISSIONERS OR CITY COUNCIL MEMBERS TO INSPECT AND ENTER THE PROPERTY THAT IS THE SUBJECT OF THIS APPLICATION. I/WE CONSENT TO ENTRY FOR THIS PURPOSE. NOTICE OF RESTRICTION: PROPERTY OWNER ACKNOWLEDGES AND CONSENTS TO A NOTICE OF RESTRICTION BEING RECORDED ON E TITLE TO HIS PROPERTY IF CONDITIONED FOR THE APPLICANT. NOTICE OF RESTRICTIONS RUN WITH THE LAND AN ANY SUCCESSORS IN INTEREST. FOR CITY USE ONLY P-1 Page 2 of6 ,, .... , ·.i-·• r·--., -1 •;\ 1 ·r· r , -, __ , ' , ... J ,/, .. I-'' 0 i,J \_ ---.• J _... -' ----' MAR O 6 2018 ClT'( OF C.:ARLS3P.D DA tE sr;c..fvlp; A:PPl'-fc~taN REdE1vEo RECEIVED BY: Revised 03/17 .. -------------l ('cicyof Carlsbad DISCLOSURE STATEMENT P-1{A) Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.gov Applicant's statement or disclosure of certain ownership interests on all applications which will require discretionary action on the part of the City Council or any appointed Board, Commission or Committee. The following information MUST be disclosed at the time of application submittal. Your project cannot be reviewed until this information is completed. Please print. Note: Person is defined as "Any individual, firm, co-partnership, joint venture, association, social club, fraternal organization, corporation, estate, trust, receiver, syndicate, in this and any other county, city and county, city municipality, district or other political subdivision or any other group or combination acting as a unit." Agents may sign this document; however, the legal name and entity of the applicant and property owner must be provided below. 1. APPLICANT (Not the applicant's agent) Provide the COMPLETE, LEGAL names and addresses of ALL persons having a financial interest in the application. If the applicant includes a corporation or partnership, include the names, titles, addresses of all individuals owning more than 10% of the shares. IF NO INDIVIDUALS OWN MORE THAN 10% OF THE SHARES, PLEASE INDICATE NON-APPLICABLE (N/A) IN THE SPACE BELOW. If a publicly-owned corporation, include the names, titles, and addresses of the corporate officers. (A separate page may be attached if necessary.) Person~ V\'U?--S Cfuw Corp/Part. __________ _ Title ~~~ Title Address 2-\ '2-0 ::S ~M~ ~ ~ ~ lJ-ddr-e-ss _________ _ Di\ M,{)£_, ' Cf. q z_.c, I 'f 2. OWNER (Not the owner's agent) P-1(A) Provide the COMPLETE, LEGAL names and addresses of ALL persons having any ownership interest in the property involved. Also, provide the nature of the legal ownership (i.e., partnership, tenants in common, non-profit, corporation, etc.). If the ownership includes a corporation or partnership, include the names, titles, addresses of all individuals owning more than 10% of the shares. IF NO INDIVIDUALS OWN MORE THAN 10% OF THE SHARES, PLEASE INDICATE NON-APPLICABLE (N/A) IN THE SPACE BELOW. If a publicly-owned corporation, include the names, titles, and addresses of the corporate officers. (A separate page may be attached if necessary.) Person f~\t;e: \f-llA--t~ Corp/Part Title ~ Title Address fB \,0 ~l'-1 0~ Address \. cµ_.c>f?P0 C,4 ci'2.co3 Page 1 of 2 Revised 07/10 - 3. NON-PROFIT ORGANIZATION OR TRUST If any person identified pursuant to (1) or (2) above is a nonprofit organization or a trust, list the names and addresses of ANY person serving as an officer or director of the non- profit-organization or as trustee or beneficiary of the. Non Profit/Trust.________ Non Profit/Trust _________ _ Title Title -------------------------- Address Address ------------------------ 4, Have you had more than $500 worth of business transacted with any member of City staff, Boards, Commissions, Committees and/or Council within the past twelve (12) months? D Yes ~ No If yes, please indicate person(s):_-,--_________ _ NOTE: Attach additional sheets if necessary. all the above information is true and cor: Si Print or type name of owner Print or type name of applicant Print or type name of owner/applicant's agent P-1 (A) Page 2 of 2 Revised 07/10 (cicyof Carlsbad PROJECT DESCRIPTION P-1(8) Development Services Planning Division 1635 Faraday Avenue {760} 602-4610 www.carlsbadca.gov PROJECT NAME: VJt,\~ ~ 0. U. APPLICANT NAME-: =====ffi-=-=\.=Ci=e===~==tA-=(te====c=~=======:s='_-_-_-_-_-_-_-_-_-_-_-_- Please describe fully the proposed project by application type. Include any details necessary to adequately explain the scope and/or operation of the proposed project. You may also include any background information and supporting statements regarding the reasons for, or appropriateness of, the application. Use an addendum sheet if necessary. Description/Explanation: P-1(8) Page 1 of 1 Revised 07/10 {'cicyof Carlsbad HAZARDOUS WASTE AND SUBSTANCES STATEMENT P-1(C) Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.gov Consultation of Lists of Sites Related to Hazardous Wastes (Certification of Compliance with Government Code Section 65962.5) Pursuant to State of California Government Code Section 65962.5, I have consulted the Hazardous Waste and Substances Sites List compiled by the California Environmental Protection Agency and hereby certify that (check one): J;17 The development project and any alternatives proposed in this application are not contained on the lists compiled pursuant to Section 65962.5 of the State Government Code. D The development project and any alternatives proposed in this application are contained on the lists compiled pursuant to Section 65962.5 of the State Government Code. APPLICANT Name: ~ ~ C-14-\~ Address:Z-ll..A> j\ \N\~ ~~ ~ll'f Cel Mf:il--,, c~ q2.e>, 4 PROPERTY OWNER Name: ~({~ l,N.\4~ Address: 4B lD fe::t¼ Oh cw l ~ n pt> ~r 9'2<2.oB Phone Number: ~ 'St> -15"r' .... S34, 3 Phone Number: -ZG:,(!) -~--1177 Address of Site: ___ fb......__\...:_O __ ~'---~l_':(-+----'(}t-:;;___\._'-<-________ _ Local Agency (City and County): ___ ~ __ "-.._S_f)_f::,0 ____ , _£~~-~..Q-~f ~~~0 __ _ / Assessor's book, page, and parcel number: __ '2-0 __ 1_,.._2-,_3_b_ ... _1_4_,-_a::) _______ _ Specify list(s): _______ ~..__./-+A _________________ _ , Regulatory Identification Number:. ___ e_/ ..... A __________________ _ Date of List: ________ J--1_,_,_,/fr:~------------------ The Hazardous Waste and Substances Sites List (Cortese List) is used by the State, local agencies and developers to comply with the California Environmental Quality Act requirements in providing information about the location of hazardous materials release sites. P-1 (C) Page 1 of2 Revised 02/13 I""' ~--~ ,-------------------------___________ ..,. 1 l ; A t'., " ... -~ CI TY OF CARLSBAD TIME LIMITS ON DISCRETIONARY PROJECTS P-1(E) PLEASE NOTE: Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.cartsbadca.gov Time limits on the processing of discretionary projects established by state law do not start until a project application is deemed complete by the City. The City has 30 calendar days from the date of application submittal to determine whether an application is complete or incomplete. Within 30 days of submittal of this application you will receive a letter stating whether this application is complete or incomplete. If it is incomplete, the letter will state what is needed to make this application complete. When the application is complete, the processing period will start upon the date of the completion letter. If you have any questfom regarding appllcatton submittal requintments (I.e., clarification regarding a specific requirement or wt1e1t11A1r all requirements are nec:essary for your particular application) please call tnt1UNiU:l,4'M~. Applicant Signature: Staff Signature: Date: To be stapled with receipt to the application P-1(E) Page 1 of 1 Revised 07/10 ( City of Carlsbad MINOR COASTAL DEVELOPMENT PERMIT/ SINGLE FAMILY RESIDENCE APPLICATION Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.gov P-6 A proposed project requiring application submittal must be submitted by appointment*. Please contact the appointment specialist at (760) 602-2723 to schedule an appointment. *SAME DAY APPOINTMENTS ARE NOT AVAILABLE All joint application exhibits, i.e. Tentative Map and Planned Development Site Plan should be prepared at the same scale. (Use a scale no smaller than 1" = 40'.) I. GENERAL BACKGROUND A. Estimated Cost of Development: Development costing $60,000 or more does not qualify as a Minor Coastal Development Permit. The City Planner shall make the final determination regarding a project's cost of development. The primary basis for determining cost of development will be the application of dollar costs per square foot for different types of residential construction. These costs are set by the International Conference of Building Officials (ICBO) and are applied throughout San Diego County. Please complete the following information to assist in the determination of this project's cost of development (Contractor proposals may also be submitted for consideration by the City Planner). Please refer to the current fee schedule for the appropriate $/square foot fee rate. ⇒ New Residential Square Footage: / 'W ,~.CC() / ZLIO square feet x $ /sq. ft.=$ -• ⇒ Residential Addition Square Footage: square feet x $ /sq. ft.=$ ⇒ Any Garage Square Footage: square feet x $ /sq. ft.=$ ⇒ Residential Conversion Square Footage: square feet x $ /sq. ft.=$ ⇒ Please contact the City of Carlsbad Building Division for current fee rate for Non- Residential uses (i.e. Retail/Store; Restaurants; Office; and Manufacturing/Warehouse uses.) ______ square feet x $ __ /sq. ft.=$ __________ _ COST OF DEVELOPMENT ESTIMATE:$ ___________ _ 8. Do you wish to apply for: 1. A Minor Coastal Development Permit (Under $60,000 cost estimate) D 2. A Coastal Development Permit ($60,000 or more cost estimate)~ C. Street address of proposed development fe\o \L({LLt' Q(2we- P-6 Page 1 of6 Revised 05/17 - D. Assessor's Parcel Number of proposed development 2-01 -'2-3c? -l 'l-0::) E. Development Description: Briefly describe project: /-0 0 l Ci)...... S . 'f. • ~-Ou. ~ ~o t-..>e.<.v CO~\t€.cC 72C S,r; f;>-A;\L f:t>x,u':C ~,Q~~ ~ ~ \ s:n ¼ G? 3 o s. ::r--, \~ ~-~ ~OU.~ stP '6'--1-,s:p>::S ->lNjle. F. Describe the present land uses (i.e. vacant land, single family homes, apartments, offices, etc.) that surround the proposed development to the: North: ~ U-,.s~ ~ 'f:t?l:1 \ vY South: $\ 1'-4 ~ 'f:1¥1 I L.,"(' East: V ~T West:_---=S-'-\_1--l_q_~_t ___ ~--'---\_V_~ ____________ _ G. Is project located within a 100-year flood plain? 0Yes ~No II. PRESENT USE OF PROPERTY A. Are there existing structures on the property? [E'Yes D No If yes~ease describe. .IJ 1_, ~\S--:0 ,-.;c, ~"":::>t0~ B. Will any existing structure be removed/demolished? D Yes [E No If yes to either question, describe the extent of the demolition or removal, including the relocation site, if applicable (also show on plans). Ill. LOT COVERAGE A. Existing and Proposed Existing Progosed Total Building Coverage 22. t4 sq. ft. lz_cosq.ft. 34(~sq.;-Z..1 Landscaped Area \ o,~2'usq. ft. °l 4'2 ~q. ft. 1 l/ 'LO sq. ft. us- Hardscape Area \ 18-0 sq. ft. t 7 cero sq. ft. t,~ sq. ft. lZ. Unimproved Area (Left Natural) cl> sq. ft. c/> sq. ft. c/ sq. ft. t P-6 Page 2 of 6 Revised 05/17 % % % % P-6 B. Parking: Number of existing spaces '3 Number of new spaces proposed __ q> ____ _ Existing/Proposed TOTAL: 3 Number of total spaces required --~~~--- Number of covered spaces P Number of uncovered spaces ___ 3 ____ _ Number of standard spaces 3 Number of compact spaces ¢ Is tandem parking existing? Is tandem parking proposed? OYes#_00No OYes# __ MNo C. Grade Alteration: Is any grading proposed? D Yes [:29 No If yes, please complete the following: 1. Amount of cut __________________ cu. yds. 2. Amount of fill cu. yds. 3. Maximum height of fill slope feet Maximum height of cut slope _____________ feet 4. 5. Amount of import or export cu. yds. 6. Location of borrow or disposal site _______________ _ Page 3 of 6 Revised 05/17 The following materials shall be submitted for each single family residence/minor coastal development permit application. If you have any questions regarding application submittal requirements (i.e., clarification regarding a specific requirement or whether all requirements are necessary for your particular application) please call (760) 602-4610. I. REQUIRED PLANS (All required plans shall be collated into complete sets, stapled together, then folded to 9" x 12" with lower right hand corner of plan visible.) P-6 A. SITE PLAN -Four (4) copies for a Minor Coastal Development Permit, four (4) copies for a Single Family Coastal Development Permit on 24" x 36" sheet(s). Five (5) copies if landscape review is required. Each site plan shall contain the following information: 1. GENERAL INFORMATION Oa. Name, address, and phone number of registered civil engineer, licensed surveyor, landscape architect or land planner who prepared the maps/plans. Ob. Location, size and use of all easements. De. Dimensions and locations of: access, both pedestrian and vehicular, showing service areas and points on ingress and egress, off-street parking and loading areas showing location, number and typical dimension of spaces, and wheel stops. 0d. Distance between buildings and/or structures. De. Building setbacks (front, rear and sides). Of. Location, height and materials of walls and fences. Og. Dimensions/location of signs. Oh. A summary table of the following (if applicable to the application): 0(1) Street address and assessor's parcel number. 0(2) Site acreage. 0(3) Existing Land Use Designation and Zoning. 0(4) Proposed land use. 0(5) Total building coverage (in square feet and as a percent). 0(6) Percent of site to be landscaped. 0(7) Number of parking spaces required/provided. 0(8) Square Footage of open or recreational space (if applicable). 0(9) Cubic footage of storage space (if applicable). Di. All applicable Fire Suppression Zones as required by the City's Landscape Manual. B. GRADING AND DRAINAGE PLANS: Grading and drainage plans must be included with this application. In certain areas, an engineering geology report must also be included. Please consult the Planning Division and Land Development Engineering Division representatives for a determination on any grading plan geotechnical requirements if the project is in an overlay zone. The following information shall be submitted at a minimum: 01. Approximate contours at 1' intervals for slopes less than 5%; 2' intervals for slopes between 5% and 10%; and 5' intervals for slopes over 10% (both existing and proposed). Existing and proposed topographic contours within a 100-foot perimeter of the boundaries of the site. Extend contours sufficiently out from the site to adequately show the adjacent floodplain (if applicable}. 02. Earthwork volumes: cut, fill, import and export. 03. Spot elevations at the corners of each pad. 04. Method of draining each lot. Include a typical cross section taken parallel to the frontage for lots with less than standard frontage. 05. Location, width and/or size of all watercourses and drainage facilities within and adjacent to the proposed subdivision; show location and approximate size of any proposed detention/retention basins. 06. Clearly show and label the 100 year flood line for the before and after conditions for any project which is within or adjacent to a FEMA flood plain. Page 4 of 6 Revised 05/17 C. BUILDING ELEVATIONS AND FLOOR PLANS -Four (4) copies for a Minor Coastal Development Permit and four (4) copies a Single Family Coastal Development Permit prepared on 24" x 36" sheet(s). Each building elevation and floor plan shall include the following information: 01. Location and size of storage areas. 02. All buildings, structures, wall and/or fences, signs and exterior lights. 03. Existing and proposed construction. 04. Provide documentation demonstrating compliance with City Council Policy 44 - Neighborhood Architectural Design Guidelines (if applicable). Os. Building Heights of all structures (top of roof and top of roof projections) D. CONCEPTUAL LANDSCAPE PLANS -Five (5) copies of the site plan shall be submitted if applicable. To determine if a landscape plan is required, consult Chapter 1-Applicability in the Landscape Manual. COLORED SITE PLAN AND ELEVATION PLAN -Not required with first submittal. It is the Applicant's responsibility to bring one (1) copy of a colored site plan and one (1) set of colored elevations to the Planning Division by 12:00 noon, eight (8) days prior to the Planning Commission meeting. Do not mount exhibits. II. REQUIRED DOCUMENTS AND SU BM ITT AL ITEMS DA A completed Land Use Review Application Form. OB. Completed Coastal Development Permit Application. DC. Environmental Impact Assessment Part 1 with Coastal Development Permits. Check with Planning staff regarding Minor Coastal Development Permits and Single Family Coastal Development Permits for any environmental review requirements. DD. Disclosure Statement. DE. Two (2) copies of the Preliminary Title Report (current within the last six (6) months). OF. Completed "Project Description/Explanation" sheet. □G. Two copies of a completed and signed "Storm Water Standards Questionnaire" (form E-34). This form can be found on the City's website. (Distribute copy to Land Development Engineering). DH. If, when completing the Storm Water Standards Questionnaire, the project is subject to "Standard Project," requirements, submit a completed and signed "Standard Project Requirement Checklist" (form E-36) in accordance with the City BMP Design Manual per the City of Carlsbad Engineering Standards, latest version. 01. If, when completing the Storm Water Standards Questionnaire, the project is defined as a "Priority Development Project," submit a preliminary Storm Water Quality Management Plan (SWQMP) prepared in accordance with the City BMP Design Manual per the City of Carlsbad Engineering Standards, latest version. Refer to the city's SWQMP template (form E-35). OJ. Property Owner's List and Addressed Labels: Single Family Residence 1. A typewritten list of the names and addresses of all property owners within a 600' radius of the subject property (including the applicant and/or owner), all occupants within a 100' radius of the subject property, and the applicable Homeowners Association (HOA). The list shall include the San Diego County Assessor's parcel number from the latest assessment rolls. P-6 Page 5 of 6 Revised 05/17 - 2. Two (2) separate sets of mailing labels of the property owners within a 600' radius of the subject property, all occupants within a 100' radius and the applicable HOA. The list must be typed in all CAPITAL LETTERS, left justified, void of punctuation. For any address other than single-family residence, an apartment, suite or building number must be included on a separate line. DO NOT include it on the street address line. DO NOT TYPE ASSESSOR'S PARCEL NUMBER ON LABELS. DO NOT provide addressed envelopes -PROVIDE LABELS ONLY. Acceptable fonts are: Arial 10, Enterprise TM or Courier NEW (TT) no larger than 11 pt. Sample labels are as follows: UNACCEPTABLE Mrs. Jane Smith 123 Magnolia Ave., Apt. #3 Carlsbad, CA 92008 UNACCEPTABLE Mrs. Jane Smith 123 Magnolia Ave. Apt. #3 Carlsbad,CA 92008 ACCEPTABLE MRS. JANE SMITH APT3 123 MAGNOLIA AVE CARLSBAD CA 92008 3. 600' Radius Map: A map to scale not less than 1 "=200' showing each lot within 600' of exterior boundaries of the subject property. Each of these lots shall be consecutively numbered and correspond with the property owners list. The scale of the map may be reduced to a scale acceptable to the City Planner if the required scale is impractical. Note: When the application is tentatively scheduled to be heard by the decision making body, the project planner will contact the applicant and advise him to submit the radius map, two sets of the property owners list and labels. The applicant shall be required to sign a statement certifying that the information provided represents the latest equalized assessment rolls from the San Diego County Assessor's Office. The project will not go forward until this information is received. Minor Coastal Development Permit 1. 100' Radius Owners and Occupants/Address List and Labels (for coastal zone/CDPs only): P-6 One (1) list of the owners and occupants/addresses located within a 100' radius of the project site; and two (2) sets of mailing labels of the addresses within a 100' radius. Sample labels are as follows: UNACCEPTABLE Occupant 123 Magnolia Ave., Apt. #3 Carlsbad, CA 92008 UNACCEPTABLE Mrs. Jane Smith 123 Magnolia Ave., Apt. #3 Carlsbad, CA 92008 UNACCEPTABLE Occupant 123 Magnolia Ave. Apt. #3 Carlsbad, CA 92008 UNACCEPTABLE Mrs. Jane Smith 123 Magnolia Ave. Apt. #3 Carlsbad, CA 92008 Page 6 of 6 ACCEPTABLE OCCUPANT APT3 123 MAGNOLIA AVE CARLSBAD CA 92008 ACCEPTABLE MRS. JANE SMITH APT3 123 MAGNOLIA AVE CARLSBAD CA 92008 Revised 05/17 ( City of Carlsbad STORM WATER STANDARDS QUESTIONNAIRE Development Services Land Development Engineering 1635 Faraday Avenue (760) 602-2750 www.carlsbadca.gov E-34 I INSTRUCTIONS: To address post-development pollutants that may be generated from development projects, the city requires that new development and significant redevelopment priority projects incorporate Permanent Storm Water Best Management Practices (BMPs) into the project design per Carlsbad BMP Design Manual (BMP Manual). To view the BMP Manual, refer to the Engineering Standards (Volume 5). This questionnaire must be completed by the applicant in advance of submitting for a development application (subdivision, discretionary permits and/or construction permits). The results of the questionnaire determine the level of storm water standards that must be applied to a proposed development or redevelopment project. Depending on the outcome, your project will either be subject to 'STANDARD PROJECT' requirements or be subject to 'PRIORITY DEVELOPMENT PROJECT' (PDP) requirements. Your responses to the questionnaire represent an initial assessment of the proposed project conditions and impacts. City staff has responsibility for making the final assessment after submission of the development application. If staff determines that the questionnaire was incorrectly filled out and is subject to more stringent storm water standards than initially assessed by you, this will result in the return of the development application as incomplete. In this case, please make the changes to the questionnaire and resubmit to the city. If you are unsure about the meaning of a question or need help in determining how to respond to one or more of the questions, please seek assistance from Land Development Engineering staff. A completed and signed questionnaire must be submitted with each development project application. Only one completed and signed questionnaire is required when multiple development applications for the same project are submitted concurrently. PROJECT INFORMATION PROJECT NAME: \}J./+~ ~~ o _ (( PROJECT ID: ADDRESS: 4--B t~ -e \l4 O-e.., '1'-1 APN: '2..01-~~b -l '1-Cb ·' The project is (check one): D New Development ~ Redevelopment The total proposed disturbed area is: l '2..C-0 ft2 ( • Ol.. 3 ) acres The total proposed newly created and/or replaced impervious area is: \,'Ulo ft2 ( ,, D 2-5 ) acres ff your project is covered by an approved SWQMP as part of a larger development project, provide the project ID and the SWQMP # of the larger development project: Project ID SWQMP#: Then, go to Step 1 and follow the instructions. When completed, sign the form at the end and submit this with your application to the city. E-34 Page 1 of 4 REV 02/16 STEP1 TO BE COMPLETED FOR ALL PROJECTS To determine if your project is a "development project", please answer the following question: YES NO Is your project LIMITED TO routine maintenance activity and/or repair/improvements to an existing building □ ,l8f or structure that do not alter the size (See Section 1.3 of the BMP Design Manual for guidance)? If you answered "yes" to the above question, provide justification below then go to Step 5, mark the third box stating "my project is not a 'development project' and not subject to the requirements of the BMP manual" and complete applicant information. Justification/discussion: (e.g. the project includes only interior remodels within an existing building): If you answered "no" to the above question, the project is a 'development project', ao to Step 2. STEP2 TO BE COMPLETED FOR ALL DEVELOPMENT PROJECTS To determine if your project is exempt from PDP requirements pursuant to MS4 Permit Provision E.3.b.(3), please answer the following questions: Is your project LIMITED to one or more of the following: YES NO 1. Constructing new or retrofitting paved sidewalks, bicycle lanes or trails that meet the following criteria: a) Designed and constructed to direct storm water runoff to adjacent vegetated areas, or other non- erodible permeable areas; □ ~ b) Designed and constructed to be hydraulically disconnected from paved streets or roads; c) Designed and constructed with permeable pavements or surfaces in accordance with USEPA Green Streets guidance? 2. Retrofitting or redeveloping existing paved alleys, streets, or roads that are designed and constructed in □ ~ accordance with the USEPA Green Streets guidance? 3. Ground Mounted Solar Array that meets the criteria provided in section 1.4.2 of the BMP manual? □ ~ If you answered "yes" to one or more of the above questions, provide discussion/justification below, then go to Step 5, mark the second box stating "my project is EXEMPT from PDP ... " and complete applicant information. Discussion to justify exemption ( e.g. the project redeveloping existing road designed and constructed in accordance with the USEPA Green Street guidance): If you answered "no" to the above questions, your project is not exempt from PDP, go to Step 3. E-34 Page 2 of4 REV 04/17 STEP3 TO BE COMPLETED FOR ALL NEW OR REDEVELOPMENT PROJECTS To determine if your project is a PDP, please answer the following questions (MS4 Permit Provision E.3.b.(1 )): 1. ls your project a new development that creates 10,000 square feet or more of impervious surfaces collectively over the entire project site? This includes commercial, industrial, residential, mixed-use, and public development proiects on public or orivate land. 2. Is your project a redevelopment project creating and/or replacing 5,000 square feet or more of impervious surface collectively over the entire project site on an existing site of 10,000 square feet or more of impervious surface? This includes commercial, industrial, residential, mixed-use, and public development proiects on public or private land. 3. Is your project a new or redevelopment project that creates and/or replaces 5,000 square feet or more of impervious surface collectively over the entire project site and supports a restaurant? A restaurant is a facility that sells prepared foods and drinks for consumption, including stationary lunch counters and refreshment stands selling prepared foods and drinks for immediate consumption (Standard Industrial Classification (SIC) code 5812). 4. Is your project a new or redevelopment project that creates 5,000 square feet or more of impervious surface collectively over the entire project site and supports a hillside development project? A hillside development project includes development on any natural slope that is twenty-five percent or oreater. 5. Is your project a new or redevelopment project that creates and/or replaces 5,000 square feet or more of impervious surface collectively over the entire project site and supports a parking lot? A parking lot is a land area or facility for the temporary parking or storage of motor vehicles used personally for business or for commerce. 6. Is your project a new or redevelopment project that creates and/or replaces 5,000 square feet or more of impervious street, road, highway, freeway or driveway surface collectively over the entire project site? A street, road, highway, freeway or driveway is any paved impervious surface used for the transportation of automobiles, trucks, motorcvcles, and other vehicles. 7. Is your project a new or redevelopment project that creates and/or replaces 2,500 square feet or more of impervious surface collectively over the entire site, and discharges directly to an Environmentally Sensitive Area (ESA)? "Discharging Directly to" includes flow that is conveyed overland a distance of 200 feet or less from the project to the ESA, or conveyed in a pipe or open channel any distance as an isolated flow from the oroiect to the ESA (i.e. not commina/ed with flows from adiacent lands).* 8. Is your project a new development or redevelopment project that creates and/or replaces 5,000 square feet or more of impervious surface that supports an automotive repair shop? An automotive repair shop is a facility that is categorized in any one of the following Standard Industrial Classification (SIC) codes: 5013, 5014, 5541, 7532-7534, or 7536-7539. 9. Is your project a new development or redevelopment project that creates and/or replaces 5,000 square feet or more of impervious area that supports a retail gasoline outlet (RGO)? This category includes RGO's that meet the following criteria: (a) 5,000 square feet or more or (b) a project Average Daily Traffic (ADT) of 100 or more vehicles per dav. 10. Is your project a new or redevelopment project that results in the disturbance of one or more acres of land and are expected to generate pollutants post construction? 11. Is your project located within 200 feet of the Pacific Ocean and ( 1) creates 2,500 square feet or more of impervious surface or (2) increases impervious surface on the property by more than 10%? (CMC 21.203.040) YES NO □ □ □ □ □ □ □ □ □ □ □ If you answered "yes" to one or more of the above questions, your project is a PDP. If your project is a redevelopment project, go to step 4. If your project is a new project, go to step 5, check the first box stating "My project is a PDP ... " and complete applicant information. If you answered "no" to all of the above questions, your project is a 'STANDARD PROJECT.' Go to step 5, check the second box statinQ "My project is a 'STANDARD PROJECT' ... " and complete applicant information. E-34 Page 3 of 4 REV 04/17 STEP4 TO BE COMPLETED FOR REDEVELOPMENT PROJECTS THAT ARE PRIORITY DEVELOPMENT PROJECTS (PDP) ONLY Complete the questions below regarding your redevelopment project (MS4 Permit Provision E.3.b.(2)): Does the redevelopment project result in the creation or replacement of impervious surface in an amount of less than 50% of the surface area of the previously existing development? Complete the percent impervious calculation below: Existing impervious area (A) = ----=+'f--'S=-?-=-7 _____ sq. ft. Total proposed newly created or replaced impervious area (B) = ___ __,_l_'LJ2;0 _______ s.q. ft. Percent impervious area created or replaced (B/A)*100 = 2..G:, % YES NO □ If you answered "yes", the structural BMPs required for PDP apply only to the creation or replacement of impervious surface and not the entire development. Go to step 5, check the first box stating "My project is a PDP ... " and complete applicant information. If you answered "no," the structural BMP's required for PDP apply to the entire development. Go to step 5, check the check the first box statin "M ro·ect is a PDP .. ." and com lete a licant information. STEPS CHECK THE APPROPRIATE BOX AND COMPLETE APPLICANT INFORMATION 0 My project is a PDP and must comply with PDP stormwater requirements of the BMP Manual. I understand I must prepare a Storm Water Quality Management Plan (SWQMP) for submittal at time of application. ~ My project is a 'STANDARD PROJECT' OR EXEMPT from PDP and must only comply with 'STANDARD PROJECT' stormwater requirements of the BMP Manual. As part of these requirements, I will submit a "Standard Project Requirement Checklist Form E-36" and incorporate low impact development strategies throughout my project. Note: For projects that are close to meeting the PDP threshold, staff may require detailed impervious area calculations and exhibits to verify if 'STANDARD PROJECT' stormwater requirements apply. D My Project is NOT a 'development project' and is not subject to the requirements of the BMP Manual. Applicant Information and Signature Box Applicant Title: -~pl? __ CJ_v\-_\~~r-=~~------ Date: _ ____.3"-+/-C..3.,._/,...../ 8~----- • Environmentally Sensitive Areas include but are not limited to all Clean Water Act Section 303(d) impaired water bodies; areas designated as Areas of Special Biological Significance by the State Water Resources Control Board (Water Quality Control Plan for the San Diego Basin (1994) and amendments); water bodies designated with the RARE beneficial use by the State Water Resources Control Board (Water Quality Control Plan for the San Diego Basin (1994) and amendments); areas designated as preserves or their equivalent under the Multi Species Conservation Program within the Cities and County of San Diego; Habitat Management Plan; and any other equivalent environmentally sensitive areas which have been identified by the City. This Box for City Use Only YES NO City Concurrence: □ □ By: Date: Project ID: E-34 Page 4 of4 REV 04/17 • (_ City of Carlsbad Project Name: \}-it·-\ t'"ie. Project ID: DWG No. or Building Permit No.: STANDARD PROJECT REQUIREMENT CHECKLIST E-36 Project Information ~. 0 -4 .. Source Control BMPs Development Services Land Development Engineering 1635 Faraday Avenue (760) 602-2750 www.carlsbadca.gov All development projects must implement source control BMPs SC-1 through SC-6 where applicable and feasible. See Chapter 4 and Appendix E.1 of the BMP Design Manual (Volume 5 of City Engineering Standards) for information to implement source control BMPs shown in this checklist. Answer each category below pursuant to the following. • "Yes" means the project will implement the source control BMP as described in Chapter 4 and/or Appendix E.1 of the Model BMP Design Manual. Discussion/justification is not required. • "No" means the BMP is applicable to the project but it is not feasible to implement. Discussion/justification must be provided. Please add attachments if more space is needed. • "N/A" means the BMP is not applicable at the project site because the project does not include the feature that is addressed by the BMP (e.g., the project has no outdoor materials storage areas). Discussion/justification may be provided. Source Control Requirement Applied? SC-1 Prevention of Illicit Discharges into the MS4 □Yes □No QfN/A Discussion/justification if SC-1 not implemented: SC-2 Storm Drain Stenciling or Signage □Yes □No p(N/A Discussion/justification if SC-2 not implemented: SC-3 Protect Outdoor Materials Storage Areas from Rainfall, Run-On, Runoff, and Wind !)(Yes □No 0 N/A Dispersal Discussion/justification if SC-3 not implemented: E-36 Page 1 of4 Revised 09/16 Source Control Requirement (continued) AJ>plied? SC-4 Protect Materials Stored in Outdoor Work Areas from Rainfall, Run-On, Runoff, and ~Yes □No D N/A Wind Dispersal Discussion/justification if SC-4 not implemented: SC-5 Protect Trash Storage Areas from Rainfall, Run-On, Runoff, and Wind Dispersal [)lYes □No D N/A Discussion/justification if SC-5 not implemented: SC-6 Additional BMPs based on Potential Sources of Runoff Pollutants must answer for each source listed below and identify additional BMPs. (See Table in Appendix E.1 of BMP Manual for guidance). D On-site storm drain inlets D Yes □No NN/A D Interior floor drains and elevator shaft sump pumps □Yes □No !)a' N/A D Interior parking garages □Yes □No [)NIA D Need for future indoor & structural pest control □Yes □No ~ N/A D Landscape/Outdoor Pesticide Use □Yes □No J:j§'N/A D Pools, spas, ponds, decorative fountains, and other water features □Yes □No ()if N/A D Food service □Yes □No tif N/A D Refuse areas □Yes □No tSill N/A D Industrial processes □Yes ONo filN/A □ Outdoor storage of equipment or materials □Yes ONo ~N/A □ Vehicle and Equipment Cleaning □Yes □No ISif N/A D Vehicle/Equipment Repair and Maintenance D Yes ONo ~N/A D Fuel Dispensing Areas □Yes □No !if N/A D Loading Docks □Yes □No ~N/A □ Fire Sprinkler Test Water □Yes □No ~N/A D Miscellaneous Drain or Wash Water □Yes □No ~N/A D Plazas, sidewalks, and oarkina lots □Yes □No 00 N/A For "Yesn answers, identify the additional BMP per Appendix E.1. Provide justification for ·No# answers. I E-36 Page 2 of 4 Revised 09/16 ' Site Design BMPs All development projects must implement site design BMPs SD-1 through SD-8 where applicable and feasible. See Chapter 4 and Appendix E.2 thru E.6 of the BMP Design Manual (Volume 5 of City Engineering Standards) for information to implement site design BMPs shown in this checklist. Answer each category below pursuant to the following. • "Yes" means the project will implement the site design BMPs as described in Chapter 4 and/or Appendix E.2 thru E.6 of the Model BMP Design Manual. Discussion / justification is not required. • "No" means the BMPs is applicable to the project but it is not feasible to implement. Discussion/justification must be provided. Please add attachments if more space is needed. • "N/A" means the BMPs is not applicable at the project site because the project does not include the feature that is addressed by the BMPs (e.g., the project site has no existing natural areas to conserve). Discussion/justification may be provided. Site Design Requirement I Applied? SD-1 Maintain Natural Drainage Pathways and Hydrologic Features I isa Yes I D No ID NIA Discussion/justification if SD-1 not implemented: I SD-2 Conserve Natural Areas, Soils, and Vegetation I □Yes I □No I Cit'N/A Discussion/justification if SD-2 not implemented: . SD-3 Minimize lmoervious Area I □Yes I □No I ~N/A Discussion[justification if SD-3 not implemented: SD-4 Minimize Soil Compaction I IO Yes I ONo ID N/A Discussion/justification if SD-4 not implemented: , SD-5 Impervious Area Dispersion I D Yes I ONo I ~N/A Discussion/justification if S0-5 not implemented: ,, . E-36 Page 3 of 4 Revised 09116 Site Design Requirement (continued) I ADDlied? SD-6 Runoff Collection I □Yes I D No I ~·NIA Discussion/justification if SD-6 not implemented: SD-7 Landscaping with Native or Drought Tolerant Species I 1'i· Yes I D No ID NIA Discussion/justification if SD-7 not implemented: SD-8 Harvesting and Using Precipitation I □Yes I ONo I [lll" N/A Discussion/justification if SD-8 not implemented: , E-36 Paga 4of 4 Revised 09/16