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Home My WebLink AboutCP 182A; Samuelson Addition; Condo Permit (CP)CITY OF CARLSBAD LAND USE REVIEW APPLICATION 1) APPLICATIONS APPLIED FOR: (C j I Administrative Permit I | Administrative Variance ( | Coastal Development Permit I I Conditional Use Permit 1^*1 Condominium Permit 1 1 Environmental Impact Assessment 1 j -General Plan Amendment 1 j Hillside Development Permit | | Local Coastal Program Amendment Master Plan 1 1 Non-Residential Planned Development | 1 Planned Development Permit :H£CK BOXES) (FOR DEPARTMENT USE ONLY) cpootet/v 1 1 Planned Industrial Permit 1 ( Planning Commission Determination Precise Development Plan j | Redevelopment Permit D Site Development Plan Special Use Permit 1 j Specific Plan n Tcntotivc Porce4 Map Obtain from Engineering Department 1 | Tentative Tract Map D Variance Zone Change List other applications not specified (FOR DEPARTMENT USE ONLY) 2) ASSESSOR PARCEL NO(S).: _ 3) PROJECT NAME: _ 4) BRIEF DESCRIPTION OF PROJECT: 5) OWNER NAME (Print or Type)&) APPLICANT NAME (Print or Type) MAILING ADDRESS MAILING ADDRESS CITY AND STATE ZIP TELEPHONE CITY AND STATE ZIP TELEPHONE Le>& 1 CERTIFY THAT 1 AM THE LEGAL OWNER AND THAT ALL THE ABOVE INFO TION IS TRUE AND CORRECT TO THE BEST OF MY /SIGNAT 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. DATE SIGNATURE DATE 1) 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 14 Rev. 04/04 PAGE1 OF€ 8) LOCATION OF PROJECT: ON THE F STREET ADDRESS SIDE OF BETWEEN (NORTH. SOUTH, EAST. WEST) (NAME OF STREET) (NAME OF STREET) AND 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) 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 EN5FRY FOR THIS.PURPOSE ^GNATURE FOR CITY USE ONLY FEE COMPUTATION RECEIVED APPLICATION TYPE FEE REQUIRED p£ro »TAL FEE REQUIRED -2^0""NOV 15 2004 CITY OF CARLSBAD PLANNING DEPT DATE STAMP APPLICATION RECEIVED RECEIVED BY:VED BY: T&L Form 14 Rev. 04/04 PAGE 2 OF 6 City of Carlsbad 1635 Faraday Avenue Carlsbad CA 92008 Applicant: SAMUELSON JACK Description CP00182A Amount 291.98 Receipt Number: R0046359 Transaction Date: 11/15/2004 Pay Type Method Description Amount Payment Check 2914 291.98 Transaction Amount: 291.98 5488 11/15/04 0002 01 02 CGP 291.48 City of Carlsbad 1635 Faraday Avenue Carlsbad CA 92008 3 Applicant: BYRNE HERBERT Description Amount CDP04055 2.22 Receipt Number: R0047199 Transaction Date: 12/29/2004 Pay Type Method Description Amount Payment Cash 2.22 Transaction Amount: 2.22 8562 12/29/04 0002 01 02 CGP 2-22 PROJECT DESCRIPTION/EXPLANATION PROJECT NAME: 23So gqg: Qes APPLICANT NAME: Cfack. D. 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: This project is a second story addition to an existing condominium of 1985 vintage. The square footage, including the enclosure of a first story porch of 251 square feet, does not modify or increase the footprint. All work details (exterior elevations, etc.) are included in the plan submitted to the Building Department. Prefect Descriptwn 10/96 Page 1 of 1 City of Carlsbad^f >M*HMMMMHMHM||M|M»aMHMMBMHpHgHpHHHMPlanning 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 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, 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 na"mes, titles, and addresses of the corporate officers. (A separate page may be attached if necessary.) Person \£a^ D. :Sgtry>ug-l*>on Corp/Part _ Title Owner Title Address Z3SQ Rv*c V&-> QM*ea\*Y, Address 2. 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 publiclv-owned corporation, include the names, titles, and addresses of the corporate officers. (A separate page may be attached if necessary.) Person 3acK 4 ^Olty ^dWUCl^fow'tyTnttfco Title OlUflgV Title Address &AC Cfe Address, CA FAX (T60) 60?-65W 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 $250 worth of business transacted with any member of City staff, Boards, Commissions, Committees and/or Council within the past twelve (12) months? DYes No If yes, please indicate person(s):. NOTE: Attach additional sheets if necessary. I ce •e information is true and correctlathe best of tny knowledge / g nature o^owner/d,ate Signature of D. 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\COUNT£R\CHSCLOSURe STATEMENT W98 Page 2 of 2 City of Carlsbad Planning Department HAZARDOUS WASTE AND SUBSTANCES STATEMENT 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 Wastes and Substances Sites List compiled by the California Environmental Protection Agency and hereby certify that (check one): 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. 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 PROPERTY OWNER Name:xRac-fc- V^- ^gtmuu^l^Qyi Name: Address: <9>3^P Rv\e OgS (^JTCuheouU^c Address: Phone Number: Phone Number: Address of Site: Local Agency (City and County):, Assessor's book, page, and parcel number:. Specify list(s): Regulatory Identification Number:. Date of List: Applicant Signature/Date Property Owner Signature/Date Admin/Counter/HazWaste 163S Faraday Avenue • Carlsbad. CA 92008-7314 « (760) 602-4600 • FAX (760) 602-8559 • www.ci.cartsbad.ca.us Property owners within 100 feet radius of 2350 Rue Des Chateaux, Carlsbad: Luke & Tina Cessaretti 2340 Rue Des Chateaux Carlsbad, CA 92008 Carol Grimes 2330 Rue Des Chateaux Carlsbad, CA 92008 Denise Hoefer & Dennis Brandmeyer 2360 Rue Des Chateaux Carlsbad, CA 92008 2303 Investors 2303 Ocean St. Carlsbad, CA 92008 The Hazardous Waste and Substances Sites (Cortese List) is a planning document 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. Government Code section 65962.5 requires the California Environmental Protection Agency to develop at least annually an updated Cortese List. Below is a list of agencies that maintain information regarding Hazardous Waste and Substances Sites. Department of Toxic Substances Control www.dtsc.ca.gov/database/calsites Calsites Hotline (916) 323-3400 State Water Resources Control Board www.swrcb.ca.gov/cwphome/lustis County of San Diego Certified Unified Program Agency (CUPA) Mike Dorsey Chief, Hazardous Materials Division Department of Environmental Health Services Hazardous Materials Management Division Mailing address: P.O. Box129261 San Diego, CA 92112-9261 (619)338-2395 Call Duty Specialis^for General Questions at (619) 338-2231 fax: (619) 338-2315 www.co.san-diego.ca.us Integrated Waste Management Board www.ciwmb.ca.gov 916-255-4021 Environmental Protection Agency National Priorities Sites ("Superfund" or "CERCLIS") www.epa.gov/superfund/sites/cursites (800) 424-9346 National Priorities List Sites in the United States www.epa.gov/superfund/sites/npl/npl.htm 5/19/03