HomeMy WebLinkAboutCP 03-09; Brittany Cove; Condo Permit (CP)CITY OF CARLSBAD
LAND USE REVIEW APPLICATION
1)
y/
v
2)
3)
4)
APPLICATIONS APPLIED FOR: (C
Administrative Permit - 2nd
Dwelling Unit
Administrative Variance
Coastal Development Permit
Conditional Use Permit
Condominium Permit
Environmental Impact
Assessment
General Plan Amendment
Hillside Development Permit
Local Coastal Plan Amendment
Master Plan
Non-Residential Planned
Development
Planned Development Permit
ASSESSOR PARCEL NO(S).:
PROJECT NAME:
HECK BOXES)
(FOR DEPARTMENT
USE ONLY)
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CPO^rO^
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(FOR DEPARTMENT
USE ONLV'i
Planned Industrial Permit
Planning Commission
Determination
Precise Development Plan
Redevelopment Permit
X!| Site Development Plan
Special Use Permit
1 Specific Plan
1 Tentative Parcel Mop
Obtain from Engineering Department
Vf/\ Tentative Tract Map
Variance
Zone Chanqe
List other applications not
specified
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BRIEF DESCRIPTION OF PROJECT: ^ ^ > T~ ^^^^y ( ?> - Tf2-* fUi^' <5 )
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5) OWNER NAME (Print or Type)
MAILING ADDRESS
CITY AND STATE ZIP TELEPHONE
CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE
INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY
KNOWLEDGE.
~"' ' ^j( ^-f^"*^**^ " I*- *'/'*& *£•
SIGNATURE DATE '
6) APPLICANT NAM7E (Print or Type) /
f<<2& &ry%Jjf~ (£>. fc,\ &i/li£r(l>&^YO
MAILING ADDRESS cUfja.^
CITY AND STATE ZIP TELEPHONE
1 CERTIFY THAT 1 AM THE LEGAL REPRESENTATIVE OF THE
OWNER ANHJHAT ALL THE £$OVE INFORMATION IS TRUE AND
^GNATURE ' ' DATE
&, *?, & { / 1 / 771&T7) BRIEF LEGAL DESCRIPTION
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 p.-. •..,.-,. PAGE 1 OF 2
8) LOCATION OF PROJECT:
ON THE
BETWEEN
(NORTH, SOUTH, EAST, WEST)
STREET ADDRESS
SIDE OF
AND
(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
(NAME OF STREET)
(NAME OF STREET!
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 MEMBERS 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
RECEIVED
CITY OF CARLSBAD
PLANNING DEPT.
DATE STAMP APPLICATION RECEIVED
RECEIVED BY:
DATE FEE PAID RECEIPT NO.
Form 16 PAGE 2 OF 2
PROJECT DESCRIPTION/EXPLANATION
PROJECT NAME:
APPLICANT NAME:
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:
Project Description 10/96 Page 1 of 1
City of Carlsbad
^ ••^'••i^HH'^^^^HV^^^^^^^^^^^^^^^^^^HPlanning 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 at the time of application submittal. Your project cannot
be reviewed until this information is completed. Please pnnt.
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 .
2.
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, title, 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_
Title
Corp/Part.
Title
Address 4402-Address
OWNER (Not the owner's agent)
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, title, 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.)
X Person
* Title
U
0 H.
Corp/Part
Title
x Address Address
1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (760) 6O2-460O • FAX (760) 602-8559
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
Title
Non Profit/Trust
Title
Address Address
4.Have you had more than S250 worth of business transacted with any member of City staff.
Boards, Commissions, Committees and/or Council within the past twelve (12) months'^
Yes No If yes, please indicate person(s):_,
/Cnx>,ff2 -
NOTE: Attach additional sheets if necessary.
I certify that all the above information is true and correct to the besj-«f my knowledge.
Signature of owner/date Signature of applicant/date
Print or type name of owner Print or type name of applicant
Signature of owner/applicant's agent if applicable/date
Print or type name of owner/applicant's agent
H:ADMIN\COUNTER\DISCLOSURE STATEMENT 5/98 Page 2 of 2