HomeMy WebLinkAboutCDP 97-13; Koop Residence; Coastal Development Permit (CDP) (8)•P)
CITY OF CARLSBAD
LAND USE REVIEW APPLICATION
1) APPLICATIONS APPLIED FOR: (C
n Administrative Permit - 2nd
Dwelling Unit
Q] Administrative Variance
El Coastal Development Permit
Q Conditional Use Permit
Q Condominium Permit
I | Environmental Impact
Assessment
Q] General Plan Amendment
Q] Hillside Development Permit
[~1 Local Coastal Plan Amendment
n Master Plan
(^] Non-Residential Planned
Development
Q] Planned Development Permit
HECK BOXES)
(FOR DEPARTMENT
USE ONLY)
??-/2.
foU$P3k
O Planned Industrial Permit
Q] Planning Commission
Determination
O Precise Development Plan
Q Redevelopment Permit
1 1 Site Development Plan
O Special Use Permit
[H Specific Plan
n Tcntotivo Parcel Map
Obtain from Engineering Department
|~| Tentative Tract Map
|~| Variance
f~1 Zone Change
I | List other applications not
specified
(FOR DEPARTMENT
USE ONLY)
2) ASSESSOR PARCEL NO(S).: /ffKJ -' Z.C9 ' /ZO~£</ ~Oo
3)
4)
PROJECT NAME:
BRIEF DESCRIPTION OF PROJECT:
5) OWNER NAME (Print or Type)
^)C-&T7~ A fC.£op
MAILING ADDRESS
\°(1D f/li/\rG,/OOC//t
CITY AND STATE ZIP
1 CERTIFY THAT 1 AM THE' LEGAL OWNER AND
INFORMATION IS TRUE AND CORRECT TO
KNOWLEDGE. *
SIGNATURE / 0
TELEPHONE
'j fj-^Lf--^ ygl
THAT ALL THE ABOVE
THE BEST OF MY
</-/•;-? 7
DATE
6) APPLICANT NAME (Print or Type)
MAILING ADDRESS
- 39/»^ —
CITY AND STATE
1 CERTIFY THAT 1 AM
OWNER AND THAT ALL
CORRECT TO THE BEST
« <ft**~ &&*!.
SIGNATURE / /
ZIP TELEPHONE
THE LEGAL REPRESENTATIVE OF THE
THE ABOVE INFORMATION IS TRUE AND
OF MY KNOWLEDGE.
> Y-/7'f7
DATE
7) BRIEF LEGAL DESCRIPTION t<^£>. niUA
\J 6 0
NOTE: A PROPOSED PROJECT REQUIRING MULTIPLE APPLICATIONS BE FILED, MUST BE SUBMITTED PRIOR TO 3:30 P.M.
A PROPOSED PROJECT REQUIRING ONLY ONE APPLICATION BE FILED, MUST BE SUBMITTED PRIOR TO 4:00 P.M.
Form 16 PAGE 1 OF 2
8) LOCATION OF PROJECT:
ON THE
BETWEEN
|^ v^*N^- *t
STREET ADDRESS
SIDE OF
(NORTH, SOUTH, EAST, WEST)(NAME OF STREET)
(NAME OF STREET)(NAME OF STREET)
9) LOCAL FACILITIES MANAGEMENT ZONE
10) PROPOSED NUMBER OF LOTS
13} TYPE OF SUBDIVISION
16) PERCENTAGE OF PROPOSED
PROJECT IN OPEN SPACE
19) GROSS SITE ACREAGE
22) EXISTING ZONING
11) NUMBER OF EXISTING
RESIDENTIAL UNITS
14) PROPOSED IND OFFICE/
SQUARE FOOTAGE
17) PROPOSED INCREASE IN
ADT
20) EXISTING GENERAL
PLAN
23) PROPOSED ZONING
12) PROPOSED NUMBER OF
RESIDENTIAL UNITS
,15) PROPOSED COMM
SQUARE FOOTAGE
,18) PROPOSED SEWER
USAGE IN EDU
21) PROPOSED GENERAL
' PLAN DESIGNATION
24) IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE NECESSARY FOR MEMBERS OF CITY
STAFF, PLANNING COMMISSIONERS, DESIGN REVIEW BOARD MEMEBERS 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
SIGNATURE
FOR CITY USE ONLY
FEE COMPUTATION
APPLICATION TYPE
TOTAL FEE REQUIRED
FEE REQUIRED
5oo
770.00
RECEIVED
APR 3 0 1997
COT OF CARLSBAD
DATE STAMP APPLICATION RECEIVED
RECEIVED BY:
DATE FEE PAID RECEIPT NO.5/DS/
Form 16 PAGE 2 OF 2
LAND USE REVIEW APPLICATION FORM
INSTRUCTIONS TO APPLICANTS
In order to streamline the application process and reduce duplication in filling out application forms,
the City has adopted a comprehensive application form to handle multiple application submittals.
The following instructions should assist you in preparing the application form for submittal to the
City:
1. Applications applied for: Check the appropriate boxes for the various application
types for which you are applying. Check with counter staff to determine required
application types needed to process your specific project.
2. Assessor Parcel No(s).: Include all assessor parcel numbers included within the
project boundary. The counter staff can assist you in determining the appropriate
assessor parcel number(s).
3. Project Name: Fill in the box with the name of the project, such as "Red Oak
Homes" or "Benson Commercial". If no name is proposed, write the last name of
the owner or applicant plus a brief description such as "Jones Condo Conversion" or
"Smith Residential Subdivision".
4. Brief Description of Project: Write down a brief description of the project. Be
specific but do not include square footage or architectural details. For example: a
neighborhood commercial center with two drive-thru restaurants; single family
detached residential project; or an industrial/office complex with three
industrial/office buildings.
5. Owner's Name, Address, Phone Number and Signature: To be filled in and signed by
the owner for all applications. Use the owner's name as it appears on the title
report.
6. Applicant's Name, Address, Phone Number and Signature: To be filled in and signed
by the applicant. If owner and applicant are the same you may write same on the
space for the name. All correspondence and contact regarding the application will be
directed to the applicant.
~l. Brief Legal Description: Provide a brief legal description of the property such as "Lot
6 of Map No. 8828 Carlsbad Tract 88-3" or "Portion of Lot I of Rancho Agua
Hedionda map 1717". Do not provide bearings and distances. A full legal
description will be contained within the title report submitted with the application.
8. Location of Project: Fill in the blanks with the street address (if appropriate),
direction and street names. For projects located in undeveloped areas not adjacent
to streets, use the nearest street from which the project will take access.
9. Local Facilities Management Zone: Write the number of the facilities management
zone within which your project is located. Ask for counter assistance in determining
which facility zone your project is located. It is important to know which facility
zone includes your project. Each facility zone must have an adopted local facilities
management plan before applications can be accepted by the City. Additionally, the
adopted facility plan for your zone may contain significant public facility
Form 16a Revised 10/96 Page 1 of 4
requirements which must be met before your project may be accepted as complete
or before construction permits are issued.
10. Proposed Number of Lots: For tentative tract maps and minor subdivisions only.
Write down the number of lots which are proposed to be created. Include remainder
parcels, open space and private street lots.
11. Number of Existing Residential Units: Write down the number of existing dwelling or
apartment units currently existing on the project site.
12. Proposed Number of Residential Units: Required for residential projects. Writedown
the total number of proposed dwelling or apartment units to be included in the
project. Include existing units which are included within the project boundary.
13. Type of Subdivisions: For tentative tract and parcel maps only. Write down the
type or types of uses included within the subdivision. For example: residential or
commercial/industrial.
14. Proposed Industrial/Office Square Footage: For all projects which propose the
creation of new industrial buildings. Write in the proposed gross square footage to
be applied for industrial/office use.
15. Proposed Commercial Square Footage: For all projects which propose the creation of
new commercial buildings. Write in the proposed gross square footage to be applied
to commercial use.
16. Open Space: Percentage of proposed project open space.
17. Proposed Increase in Average Daily Traffic (ADT): Write down the projected increase
in traffic generation which will result as a consequence of approval of your proposed
project. Use the traffic generation rates as determined by the latest San Diego
Association of Government Traffic Generation Rate Guide (attached).
18. Proposed Sewer Usage in Equivalent Dwelling Units: One equivalent dwelling unit
(EDU) is the average of sewer generated by one house or dwelling. One EDU is
equivalent to 220 gallons per day of sewer usage. Use the attached EDU chart to
determine the sewer usage for your project. Ask for assistance at the counter if you
are unsure how to determine your usage.
For industrial projects use the following assumptions:
a. Undeveloped industrial assumes 30% building coverage.
b. Improved lot industrial assumes 40% building coverage.
c. For shell or unknown industrial building usage assumes 1 EDU for each 1,800
square foot.
19. Gross Site Acreage: Write down the total acreage of the property over which your
proposed project is situated. Not necessary for Zone Code Amendments or
Variances.
20. Existing General Plan Designation: Write down the general plan designation(s) for
the property covered by your proposed project. Ask for counter assistance if you do
not know your general plan designation.
Form 16a Revised 10/96 Page 2 of 4
21. Proposed General Plan Designation: Required only if your project involves a request
for a general plan amendment. If so, write in the proposed general plan designation
for the property.
22. Existing Zoning: Write down the existing plan designation for your proposed project
property. Ask counter staff for assistance if you do not know your zone designation.
23. Proposed Zoning: Required only if your project involves a request for a zone change.
If so, write in the proposed zone designation(s).
24. Consent to Allow Entrance onto the Property: Signature granting members of City
staff, Planning Commissioners, Design Review Board Members or City Council
members permission to inspect and enter the property.
Application Submittal Requirements: Attached with the application form are the various
submittal requirements for each application type listed on the face of the application.
Follow any instructions contained within the submittal requirements and submit the
information and materials required for each of the applications for which you are applying.
IMPORTANT: Check all submittals to be sure all the required information and materials
have been submitted with your application. Incomplete submittals will not be processed or
schedule for review by staff, the Commission or Council. You will be notified in writing
within 30 days of submittal whether or not your application is complete.
A proposed project requiring multiple applications be filed must be submitted prior to 3:30
p.m. A proposed project requiring only one application be filed must be submitted prior to
4:00 p.m.
v Fire Department/Water District Consultation: Prior to submittal of an application for
development in the City, you are encouraged to consult with the Fire Department and the
appropriate water district in order to design your project in compliance with their
requirements. Failure to consult with either agency could result in unnecessary delays,
redesign or project denial. The purpose of the notice is to get projects to "design in" water
and fire requirements in advance.
Applicant Disclosure Form: All applications require submittal of an applicant disclosure
vjorm. Follow the instructions provided on the form and the attached information sheet.
Circulation Impact Analysis: All applications which propose an increase in the traffic
generation rate of 500 vehicles or more, over existing traffic generation for the site, must
submit a Circulation Impact Analysis. This analysis will be used to determine compliance
of your project with Growth Management Facility Standards. The analysis is not to be
considered in lieu of project related traffic studies which may be required by staff to
analyze specific project related on and off site traffic issues.
^ Hillside Development Permit: A Hillside Development Permit is required for all projects with
a slope of 15% or more and an elevation differential greater than fifteen (15) feet. Check
with City staff if you are uncertain whether or not your proposed project site requires a
Form 16a Revised 10/96 Page 3 of 4
Hillside Development Permit. If required, follow the instructions provided on the application
form.
J Environmental Impact Assessment Form: All applications for development require submittal
of an Environmental Impact Assessment Form. Larger projects or projects in
environmentally sensitive areas may require more detailed Environmental Impact Reports.
Follow the instruction provided with the application form.
^Coastal Development Permit: Applicants shall consult Community Development staff to
determine whether a Coastal Permit is required for their proposal.
Form 16a Revised 10/96 Page 4 of 4
City of Carlsbad
Planning Department
DISCLOSURE STATEMENT
APPLICANTS STATEMENT OF DISCLOSURE OF CERTAIN OWNERSHIP INTERESTS ON ALL APPLICATIONS WHICH WILL REQUIRE
DISCRETIONARY ACTION ONT HE PART OF THE CITY COUNCIL, OR ANY APPOINTED BOARD, COMMISSION OR COMMITTEE.
(Please Print)
The following information must be disclosed:
1. Applicant
List the names and addresses of all persons having a financial interest in the application.
\«=\-?o • fM .a-Q-»4 ol'i
2. Owner
List the names and addresses of all persons having any ownership interest in the property involved.
3. If any person identified pursuant to (1) or (2) above is a corporation or partnership, list the names and addresses of all
individuals owning more than 10% of the shares in the corporation or owning any partnership interest in the partnership.
4. If any person identified pursuant to (1) or (2) above is a non-profit organization or a trust, list the names and addresses
of any person serving as officer or director of the non-profit organization or as trustee or beneficiary of the trust.
FRM 13 4/91 Page 1 of 2
2O75 Las Palmas Drive • Carlsbad, California 92OO9-1576 • (619)438-1161
Disclosure Statement
(Overt
Page 2
5. Have you had more than $250 worth of business transacted with any member of City staff.
Boards, Commissions, Committees and Council within the past twelve months?
Yes No C If yesf please indicate person (s)
PERSON is defined as: "Any individual, firm copartnership, joint venture, association, social club, fraternal organization, corporation, estate,
trust, receiver, syndicate, this and any other county, city and county, city municipality, district or other political subdivision, or any other
group or combination acing as a unit."
(NOTE: Attach additional pages as necessary.)
Signature of Owner/date Signature of applicant/date
Print or type name of owner Print or type name of applicant
FRM 13 4/91 Page 2 of 2
+ SUPPLEMENTAL APPLICATION FORM FOR ALL
COASTAL DEVELOPMENT PERMITS
4 APPLICATION CHECKLIST FOR SINGLE FAMILY
REGULAR AND MINOR COASTAL DEVELOPMENT
PERMITS
(Application checklist for Non-Single Family Regular Coastal Development Permits
covered under separate handout)
This supplemental application is to be filed for any development requiring a Coastal
Development Permit issued by the City of Carlsbad.
Please answer all questions. Where questions do not apply, please indicate "not
applicable" or "N/A".
I. GENERAL BACKGROUND
A. Do you wish to apply for:
1. A Minor Coastal Development Permit
2. A Regular Coastal Development Permit v
B. Street address of proposed development
C. Assessor's Parcel Number of proposed development
D. Development Description:
1 . Briefly describe project: J5/ ^4 <-•<
I^U^U^ Qj^ideA
t /=;».. UA
4^f frcj£.T\ "^ • <j
2. Estimated cost of development:CD 1 *"1 /*) •* l»i»,^~>j / tx 1 t/ U t^ • 0O
E. Describe the present land uses (i.e. Vacant land, single family homes,
apartments, offices, etc.) that surround the proposed development to the:
North: ,^/nlg- MLC^\ 'Un,
South:
East: ^trtVte^ <HZMils- fa
West: (]y^diLveJ(&t2*Jck. Cj/ujhe.
F. Is project located within a 100 year flood plain? Q Yes \%\ No
Form 15 9/96 Page 1 of 6
II. PRESENT USE OF PROPERTY
A. Are there existing structures on the property?
If yes, please describe.
No
B. Will any existing structure be demolished? Q Yes
Will any existing structure be removed/demolished? Q Yes
If yes to either question, describe the extent of the demolition or removal,
including the relocation site, if applicable (also show on plans).
III. LOT COVERAGE
A. Existing and Proposed
Building Coverage
Landscaped Area
Unimproved Area
(Left Natural)
B. Parking:
C.
Existing
_Q sq. ft.
0 sq. ft.
_sq. ft.
Number of existing spaces
Number of new spaces proposed
Existing/Proposed TOTAL:
Number of total spaces required
Number of covered spaces
Number of uncovered spaces
Number of standard spaces
Number of compact spaces
Is tandem parking existing?
Is tandem parking proposed?
Grade Alteration:
Is any grading proposed?
If yes, please complete the following:
1. Amount of cut / 00
2. Amount of fill ^ioO
3. Maximum height of fill slope /V/ fr
New Proposed
&1i
llli
0
sed
ed
C
r
1 sq. ft. 2ft
' sq.ft. lit
sq. ft. ^B
A//A-
ti/fr
fifttr
ttlk
tiltr
/V//A
I
] Yes#
1 Yes#
Total
BLsq. ft.i
7&~ sq. ft.
C?$sg. tt.
™NO
Yes
cu. yds.
cu. yds.
feet
Form 15 9/96 Page 2 of 6
4. Maximum height of cut slope _ j_ _ feet
5. Amount oWfnporJ)or export Vfip _ cu. yds.
v, n-—"**^
6. Location of borrow or disposal site _ N
Grading and drainage plans must be included with this application. In certain
areas, an engineering geology report must also be included. Consult the City
Planning and Engineering Department representative for a determination on
any grading plan geotechnical requirements.
IV. ENVIRONMENTAL REVIEW
Submit Environmental Impact Assessment (EIA) Part I with Regular Coastal
Development Permits; check with Planning Staff regarding Minor Coastal
Development Permits and Single Family Regular Coastal Development Permits for
any environmental review requirements.
V. GENERAL APPLICATION REQUIREMENTS
(For Single Family Regular and Minor Coastal Development Permits; Regular
Coastal Development Permits covered under separate handout)
Site Plan: Four (4) copies for a Minor Coastal Development Permit, two (2)
copies for a Single Family Regular Coastal Development Permit prepared on
a 24" x 36 sheet(s) folded to 81/£" x 11". The site plan shall include the
following information:
1 . Gefteral
Name and address of applicant, engineer and/or architect, etc.
Location, size and use of all easements.
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.
Distance between building and/or structures.
Building setbacks (front, rear and sides).
Location, height and materials of walls and fences.
Dimensions/location of signs.
Elevations of all sides of all buildings.
A summary table indicating the following information (if applicable to
the application):
(1) Site acreage
(2) Existing zone and land use
(3) Proposed land use
(4) Total building coverage ^
(5) Building square footage S
(6) Percent landscaping \s
--f7)~ Number of parking spaces
-{8)- Square footage of open/recreational space (if applicable)
Cubic footage of storage space (if applicable)
Form 15 9/96 Page 3 of 6
i.
Building and floor plans: Four (4) copies for a Minor Coastal Development
Permit and two (2) copies for a Single Family Regular Coastal Development
Permit, prepared on 24" x 36" sheets folded to BY? x 11" size. The building
and floor plans shall include the following:
1. Location and size of storage areas (if applicable)
2. All buildings, structure, walls and/or fences, signs and exterior lights.
3. Existing and proposed construction.
n&duocd iito plan: One (1) copy of QYt" x 11". (Not required for Single Family
Residence).
Location Map: One (1) copy of 81/2n x 11" (suggested scale 200" - vicinity
maps on the site plan are not acceptable).
E. Colored Site Plan and Elevation Plan: (Not required with the first submittal) It
is the Applicant's responsibility to bring one (1) copy of a colored site plan and
one (1) copy of a colored elevation to the Planning Department by 12:00
noon, eight (8) days prior to the Planning Commission meeting. Do not
mount exhibits.
VI. REQUIRED DOCUMENTS
'/A. Land Use Review Application Form
Completed Coastal Development Supplemental Application Form
Disclosure Statement
"D. Completed "Project Description/Explahation" Sheet
VII. OTHER REQUIREMENTS •
A. Property Owners List and Address Labels
NOTE: When the application is tentatively scheduled to be heard by the
decision making body, theDrojeeijDlanner will contact the applicant and
advise him to submit tbe^amush^apV'two (2) sets of the property owners
list and labels. The appliuaiirsfiiil 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
rd until this information is received.
A typewritten list of the names and addresses of all property owners
within a 600' radius of subject property (including the applicant and/or
owner). The list shall include the San Diego County Assessor's parcel
number from the latest assessment rolls.
2. Two (2) separate sets of mailing labels of the property owners within a
600' radius of the subject property. 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: Swiss
Form 15 9/96 Page 4 of 6
721, Enterprise TM or Courier NEW (TT) no larger than 11 pt. Sample
labels are as follows:
UNACCEPTABLE UNACCEPTABLE ACCEPTABLE
Mrs. Jane Smith Mrs. Jane Smith MRS JANE SMITH
123 Magnolia Ave., Apt #3 123 Magnolia Ave. APT 3
Carlsbad, CA 92008 Apt. #3 123 MAGNOLIA AVE
Carlsbad, CA 92008 CARLSBAD, CA 92008
B. 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
Planning Director if the required scale is impractical.
C. 100* Radius Occupants/Address List and Labels (for coastal zone/CDPs
only): One (1) list of the occupants/addresses located within a 100' radius of
the project site; and two (2) sets of labels (as described in "A" above) of the
addresses within a 100' radius.
D. Fees and Deposit for Publication of Notices: See Fee Schedule for
amount.
VIII. SPECIFIC APPLICATION REQUIREMENTS
(May apply to single family, regular and minor coastal development permits)
Coastal Overlay Zones require additional information to be submitted as follows:
far, (refer to the Municipal Code for a full description):
A. Coastal Agriculture Overlay Zone
1. Refer to the Carlsbad Municipal Code Section 21.202.060 for specific
requirements.
B. Coastal Resource Protection Overlay Zone
1. Slope analysis/mapping for 25% and greater subject to Section
21.203.040 of the Carlsbad Municipal Code.
2. Topographic and vegetation mapping/analysis subject to Subsection
21.203.040(B)(1) of the Carlsbad Municipal Code, if project is located
along the first row of lots bordering Buena Vista Lagoon including the
Lagoon mouth.
3. Topographic, drainage and wetland mapping subject to Subsections
21.203.040(B)(2)(a) and (b) of the Carlsbad Municipal Code if located
east of Interstate 5 in the Batiquitos Lagoon watershed.
4. Drainage study subject to Subsection 21.203.040(B)(3) of the
Carlsbad Municipal Code if project is located west of existing Paseo
del Norte, west of Interstate 5 or along El Camino Real immediately
upstream of existing storm drains.
Form 15 9/96 Page 5 of 6
5. Geologic report addressing landslides and slope stability subject to
Subsection 21.203.040(B)(4) of the Carlsbad Municipal Code.
6. Geologic report addressing land slides and seismic hazards subject to
Subsection 21.203.040(C) and (D) of the Carlsbad Municipal Code.
C. Coastal Shoreline Development Overlay Zone
1. Geotechnical report subject to 21.204.110 if project is located adjacent
to an existing seabluff edge between the sea and the first public road
parallel to the sea; also may be required by Planning Director if
deemed necessary consistent with Section 21.204.110 of the Carlsbad
Municipal Code.
2. Show all structures and decks on adjacent north and south properties
to perform "stringline" test subject to Subsection 21.204.050(6) of the
Carlsbad Municipal Code.
3. Unless otherwise submitted project in this zone must also be
submitted with plans showing:
a. Boundaries and topography
b. Existing and proposed structures
c. Circulation
d. Drainage
e. Finished topography
f. Landscaping
D. Coastal Resource Overlay Zone Mello I LCP Segment
1. Erosion, sedimentation and drainage report subject to Section
21.205.060 of the Carlsbad Municipal Code if project is located in the
Batiquitos Lagoon watershed.
IX. REQUIRED COASTAL PERMIT FINDINGS
Approval of a regular or minor coastal development permit is based on the ability to
make three coastal related findings. These three findings are presented below for
your review and information.
1. That the proposed development is in conformance with the Certified Local
Coastal Program and all applicable policies.
2. That the development is in conformity with the public access and public
recreation policies of Chapter 3 of the Coastal Act.
3. That the development conforms with any applicable decision pertinent to this
proposal and/or site as set by the Coastal Commission on a previously
related appeals decision per Public Resources Code §30604(c).
Form 15 9/96 Page 6 of 6
City of Carlsbad
Planning Department
DISCLOSURE STATEMENT
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:
1. APPLICANT
List the names and addresses of all persons having a financial interest in the
application.
/?7/? /yi^^iiJfiUfi- f~&r(f.
OWNER
List the names and addresses of all persons having any ownership interest in the
property involved.
C*141D
If any person identified pursuant to (1) or (2) above is a corporation or partnership,
list the names and addresses of all individuals owning more than 10% of the shares
in the corporation or owning any partnership interest in the partnership.
Nlfr
If any person identified pursuant to (1) or (2) above is a non-profit organization or a
trust, list the names and addresses of any person serving as officer or director of
the non-profit organization or as trustee or beneficiary of the trust.
"4
2O75 Las Palmas Dr. - Carlsbad, CA 92009-1576 • (619) 438-1161 • FAX (619) 438-0894
5. Have you had moi _ than $250 worth of business transited with any member of
City staff. Boards, Commissions, Committees and/or Council within the past twelve
(12) months?
Yes pfh No If yes, please indicate person (s): <£Vn AA
[k/pr
Person is definedI ast "Any'individual, firm, co-partniareh^"joint"yenliireirassociation; social club,
fraternal organization, corporation, estate, trust,-receiver,, syndicate, 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." -.,__..!..,„.,, ... „:,...,.<.
NOTE: Attach additional sheets if necessary.
Signature of owner/ojate ' Signature of applicant/da
A *
Print or type name of owner Print or type name of applicant
Disclosure Statement 10/96 Page 2 of 2
PROJECT DESCRIPTION/EXPLANATION
PROJECT NAME: f\6op
APPLICANT NAME:
Please describe fully the proposed project. 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. •»
R«v.
PLEASE NOTE:
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.
Applicant Signature:
Staff Signature:
Date: *-f'
To be stapled with receipt to application
Copy for file
CITf OF CARLSBAD
1LLAGE DRIVE CARLSBAD, CALIFORNIA 92008
434-2867
DATE
DESCRIPTION
COP
AMOUNT
VkUu ou
4562 04/30/9?0001 01 3 $£>$0
C-WHT 97D-00
NOT VALID UNLESS VALIDATED BY
CASH REGISTER
TOTAL llfl M
Account No. 0013210 4817
CITY OF CARLSBAD
REQUEST FOR REFUND
Amount of Refund $ 291.31
Date Fee Paid: */30/97
Fee Paid
Vendor No.
-13 ~ Koop Residence
• .1
Fee Paid Ry Lgura Koop
Facts Supporting Request: Hnused Noticing fae,:^>:
of Applicant: Scott Koop
Address: 1970 Magnolia Carlsbad CA 92008 (760) 434-3481
Street
Signature of Applicant: )£.
City State Zip Telephone
&,
r
' ' ' M •
Dept. Justification:
0 Approve 1
Finance InvestigatibrYr --* .
Rec: . r
; D Approve ,s
City Manager's Action:
-Q— Approve
,-""~~~7"x
D Disapprove
D Disapprove
Q, . Disapprov.e, , , ,
^JU^. N^H^
Dept. Hea^ Signature
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<•>•* AJ^l ^atf^Bi. f*' A ^ V'•""*rr"''uity wafWyer signature —
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Date
Date
Date
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Account No. 0013210 4812
CITY OF CARLSBAD
REQUEST FOR REFUND
Amount of Refund $ 220.00 Fee Paid For:
Date Fee Paid: April 30, 1997 Fee Pajd By. Laura Koop
Vendor No.
C^P §7^I3> - Koop Residence
Facts Supporting Request: Project is exempt from Environmental Review
Name of Applicant: Scott A. Koop
Address: 1970 Magnolia Carlsbad CA 92008 (760) 434-3481
Street
Signature of Applicant: J&<
City State Zip
Date
Telephone
' / / "''
Dept
Rec:
Finar
Rec:
City
. Justification:
H Approve D Disapprove
ice Investigation:
D Approve D Disapprove Dept
Manager's Action: n ,
. — i ^^ — _ . / 1/
, • ^Aw/s)
Date
. Head Signature Date
//f^L ^.^~u/Mpprove u Disapprove Cify MaHa|el^ignatuVJ Date
I HEREBY CERTIFY THAT THE PROPERTY OWNERS LIST AND LABELS
SUBMITTED TO THE CITY OF CARLSBAD ON THIS DATE REPRESENT THE
LATEST AVAILABLE INFORMATION FROM THE EQUALIZED ASSESSOR'S ROLES.
APPLICATION NAME AND NUMBER
-< 3
APPLICANT OR APPLICANT'S REPRESENTATIVE
BY:
DATE:
RECEIVED BY
DATE:
CITY OF CARLSBAD
1200 CARLSBAD \ 4.AGE DRIVE CARLSBAD, C> FORNIA 92008
434-2867
REC'D FROM DATE
ACCOUNT NO.
C /Vmi"t
RECEIPT NO. 39^12
® Printed on recycled paper.
DESCRIPTION
Po$\a^t ,418 ()5/29/97
Q pf> ^>f3
NOT VALID UNLESS VALIDATED BY TOTAL
CASH REGISTER
AMOUNT
•3001 01 '«P &T
C-PRHT 5|>-04
6" 6" &U~T