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