HomeMy WebLinkAboutCT 97-15; Lohf Property; Tentative Map (CT)CITY OF CARLSBAD
LAND USE REVIEW APPLICATION
"1) APPLICATIONS APPLIED FOR: (C
[] Administrative Permit - 2nd
Dwelling Unit
|~] Administrative Variance
[X| Coastal Development Permit/'"' f\ ('
O Conditional Use Permit
Q Condominium Permit
[y| Environmental Impact
Assessment
Q General Plan Amendment
£$ Hillside Development Permit >j{\f
13 Local Coastal Plan Amendment
/^°A
O Master Plan
Q Non-Residential Planned
Development
O Planned Development Permit
HECK BOXES)
(FOR DEPARTMENT
USE ONLY)
"tfc&t
^n-ib<?)<%
|~~| Planned Industrial Permit
n Planning Commission
Determination
|~1 Precise Development Plan
|~1 Redevelopment Permit
Q Site Development Plan
I | Special Use Permit
O Specific Plan
Q Tentative Parcel Mop
Obtain from Engineering Department
[X] Tentative Tract Map ~ s<
Q Variance
0 Zone Change
X- ^
Q List other applications not
specified
(FOR DEPARTMENT
USE ONLY)
*r?-i<r
3l-O(a
2)
3)
4)
ASSESSOR PARCEL NO(S).:
PROJECT NAME:
215-050-59 & 18
Lohf Property - Residential Subdivision
BRIEF DESCRIPTION OF PROJECT:Single family detached residential subdivision on 36.67
acres.
5) OWNER NAME (Print or Type)
Lohf Trust, 6/22/92 and Alice M. Lanplugh. Trust ,3/9/89
Attn: Richard & Linda Ichf and Ron tfedley
MAILING ADDRESS
1425 Via Del Corvo
CITY AND STATE ZIP TELEPHONE
San Marcos CA 92069
1 CERTIFY THAT 1 AM THE LEGAL OWNER AND THAT ALL THE ABOVE
INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY
KNOWLEDGE. LJ&J&&. - Ji—^XO€^c>C(2~^>N^v/. \ ^//sr/C?
SIGNATURE ^^^i1^^./) ^^f H^^^i'^.^W
6) APPLICANT NAME (Print or Type)
Western Pacific Itusing for MMD Reusing, Inc.
Attn: Scot Sandstran
MAILING ADDRESS
2385 Camino Vida Roble, Suite 107
CITY AND STATE ZIP TELEPHONE
Carlsbad CA 92009 760-929-1600
1 CERTIFY/THAT 1 AM THE LEGAL REPRESENTATIVE OF THE
OWNER/^ND THAT ALL THE ABOVE INFORMATION IS TRUE AND
CORRECT TO THE BEST OF MY KNOWLEDGE.
/7((^-^ IK/I j^ O ^//0/9"7
./IGNATURE DATE
7) BRIEF LEGAL DESCRIPTION Parcel 2 of Map No. 2244, San Diego Crjunty, Filed 1/10/74; & The S 1/2 of
the NE 1/4 Sect.26, Tbwnship 12 S, Rar^e 4W, San Bsmardino l^feridian, Qxmty of
NOTE: A PROPOSED PROJECT REQUIRING MUTr!® 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:Dove Lane
ON THE
STREET ADDRESS
West SIDE OF
(NORTH, SOUTH, EAST, WEST)
BETWEEN Palomar Airport Road AND
El Camino Real
(NAME OF STREET)
Alga Road
(NAME OF STREET)
9) LOCAL FACILITIES MANAGEMENT ZONE
10) PROPOSED NUMBER OF LOTS
Zone 21
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 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
CT [*sr
MOP
TOTAL FEE REQUIRED
FEE REQUIRED
1 75"
3'Hlo
SEP 1 8 1997
CITY OF CARLSBAD
PLANNING DEPT.
DATE STAMP APPLICATION RECEIVED
RECEIVED BY:
DATE FEE PAID
/ /_
/ '
RECEIPT NO.
Form 16 PAGE 2 OF 2
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.
Lamco Housing, Inc.
2385 Camino Vida Roble,
Suite 107
Carlsbad, CA 92009
2. OWNER
List the names and addresses of all persons having any ownership interest in the
property involved.
Lohf Trust, 6/22/92
Alice M. Lamplugh Trust, 3/9/89
1425 Via Del Corvo
San Marcos, CA 92069
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.
Gene Rosenfeld
300 No. Continental Ave
Suite 390
El Segundo, CA 90245
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.
Richard Alexander Lohf and Pnn Hadley
Linda Jean Lohf (Successor Trustee of Alice Lamplugh Trust)
(Trustees of Lohf Trust)
1425 Via Del Corvo
San Marcos, CA 92069
2O75 Las Palmas Dr. - Carlsbad, CA 92OO9-1576 - (619) 438-1161 • FAX (619) 438-O894
•
" ' ' • '' : ; A •than $250 worth of business tran^pted with any member of
City1 staff, Boards', Commissions, Committees and/or Council within the past twelve
(12) .months?
Yes No If yes, please indicate person(s):.
Person is defined as "Any individual, firm, co-partnership, 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 Apolitical Subdivision or any other group or
combination acting-as.a unit."
NOTE: Attach additional sheets if necessary.
Lohf Trust'/ Dated Jiine 22, 1992
Richard A. Lohf & Linda: J. Lohf
Print or type name of owner Trustees
ignature of applicant/date
Lance Waite, LAMCO Housing, Inc.
Print or type name of applicant
Disclosure Statement 10/96 Page 2 of
•5. Have you had rhlfPe than $250 worth; of business trarflcted with any member of
City staff, Boards', Commissions, Committees and/or Council within the past twelve
(12) months?
| I Yes [x] No If yes, please indiqate person(s): ;
Person is defined as "Any *individual,4firrrj,tco-:partnershipf,joint venture, association, social club,
ifraternal organization,-corproration/estatetrtrust,*receiver, syndicate, this and any other county, city
and county, xity '•municjpality,"stdistr}ct%r^otRer^bolJttcal»iSilbdivision or any other group or
combination artingras^^rt^r ig^f S|', j%^$™g£?\. ~:'
NOTE: Attach aidditional sheets if necessary.
Signature of; owner/date Signature of applicant/date
Alice M. Lamplugh Trust Agreement; 3/9/89Ron Hadley, Successor Trustee
Print or type name of owner Print or type name of applicant
Disclosure Statement 10/96 Page % of
PROJECT DESCRIPTION/EXPLANATION
PROJECT NAME: Lohf Property
APPLICANT NAME: Western Pacific Housing for LAMCO Housing. Inc.
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:
The proposed Lohf Property project is a residential subdivision on two existing parcels totaling
36.67 acres in size, located in Growth Management Zone 21. The project includes a Tentative
Map for 76 detached, single family lots (minimum 7,500 square feet) with 7 open space lots and
related Hillside Development and Coastal Development Permit applications. The project
preserves dual criteria slopes and sensitive habitat area and sets such areas aside in proposed
open space lot areas. A Zone Change and associated Local Coastal Program Amendment is
requested to change the existing zoning from Limited Control (L-C) to Single Family Residential
(R-1-7500), consistent with the underlying general plan and certified LCP.
Rev. 4/91 PrqjDesc.frm
SUPPLEMENTAL APPLICATION FORM FOR ALL
COASTAL DEVELOPMENT PERMITS
APPLICATION CHECKLIST FOR SINGLE FAMILY
REGULAR AND MINOR COASTAL DEVELOPMENT
PERMITS
(Application checklist for NorhSingle Family Regular CoasfflD&tek^entP
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
applicable" or "N/A".
qpp 1 Q igQ7I. GENERAL BACKGROUND '" ^ mi
A. Do you wish to apply for: ^ OF CARLSBAD
PLANNI^DEPT1 . A Minor Coastal Development Permit
2. A Regular Coastal Development Permit x
B. Street address of proposed development
Dove Lane
C. Assessor's Parcel Number of proposed development
215-050-59 & 18
D. Development Description:
1 . Briefly describe projects ingle family detached residential
subdivision on 36.67 acres with 83 total lots (76 residential
and 7 open space) _
2. Estimated cost of development: $9,i500,ooo _
E. Describe the present land uses (i.e. Vacant land, single family homes,
apartments, offices, etc.) that surround the proposed development to the:
North: Vacant land and 1 SFD
South: SF . Subdivision
East: Vacant land
West: Vacant land
F. Is project located within a 100 year flood plain? Q] Yes j|x] No
Form 15 9/96 Page 1 of 7
II. PRESENT USE OF PROPERTY
A. Are there existing structures on the property? Q Yes Q No
If yes, please describe.
3 single family homes
B. Will any existing structure be demolished? 0 Yes Q No
Will any existing structure be removed/demolished? Q Yes 0: No
If yes to either question, describe the extent of the demolition or removal,
including the relocation site, if applicable (also show on plans).
The 3 homes will be demolished for construction
of the subdivision.
LOT COVERAGE
A. Existing and Proposed
Existing New Proposed Total
Building Coverage N/A Sq. ft. N/A sq. ft. N/A sq. ft.
Landscaped Area N/A sq. ft. 253,570 sq. ft. 253,570 sq.ft.
Unimproved Area
(Left Natural) N/A sq. ft. 348,480 sq. ft348,480 sq. ft.
B. Parking: Number of existing spaces 6 to be removedPropose:Number of new spaces proposed 2 car garage/76 lots
Existing/Proposed TOTAL: 152
Number of total spaces required 152
Number of covered spaces *
Number of uncovered spaces
Number of standard spaces 152
Number of compact spaces N/A
Is tandem parking existing? Q Yes # 0 No
Is tandem parking proposed? | | Yes # [x] No
C. Grade Alteration:
Is any grading proposed? j{x] Yes Q No
If yes, please complete the following:
1. Amount of cut 170,200 cu. yds.
2. Amount of fill 236,600 cu yds
3. Maximum height of fill slope 40 feet
Form 15 9/96 Page 2 of 7
4. Maximum height of cut slope 30 feet
None with Poinsettia
5. Amount Of import or export Lane aradi-na onsite CU. yds.
6. Location of borrow or disposal site N/A
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)
A. Site Plan: Four (4) copies for a Minor Coastal Development Permit, four (4)
copies for a Single Family Regular Coastal Development Permit prepared on
a 24" x 36 s.heet(s) folded to 81/2" x 11". The site plan shall include the
following information:
1. General
a. Name and address of applicant, engineer and/or architect, etc.
b. Location, size and use of all easements.
c. 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.
d. Distance between building and/or structures.
e. Building setbacks (front, rear and sides).
f. Location, height and materials of walls and fences.
g. Dimensions/location of signs.
h. 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
(6) Percent landscaping
(7) Number of parking spaces
(8) Square footage of open/recreational space (if applicable)
(9) Cubic footage of storage space (if applicable)
B. Building elevations (all sides of all buildings) and floor plans: Four (4) copies
for a Minor Coastal Development Permit and four (4) copies for a Single
Family Regular Coastal Development Permit, prepared on 24" x 36" sheets
folded to 8>2" 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.
Form 15 9/96 Page 3 of 7
i
STATEMENT OF AGREEMENT CARLSBAD
RECEIVED
SEP 18 1997
QF CARLS
TENTATIVE SUBDIVISION MAP PLANNING DEPT.
CITY OF CARLSBAD
The Subdivision Map Act, and the Carlsbad Municipal Code sets a fifty (50) day time restriction
on Planning Commission processing of Tentative Maps and a thirty (30) day time limit for City
Council action. These time limits can only be extended by the mutual concurrence of thei i " ' ' i '''('' ' J •applicant and the City.'1 By accepting applications for Tentative Maps concurrently with
applications for other1 approvals which are prerequisites to the map; i.e., Environmental
Assessment, Environmental Impact Report, Condominium Plan, Planned Unit Development, etc.,
the fifty (50) day time limits and the thirty (30) day time limits are often exceeded. If you wish
to have your application processed concurrently, this agreement must be signed by the applicant
or his agent., If you choose not to sign the statement, the City will not accept your application
for the Tentative Map until all prior necessary entitlements have been processed and approved.
The undersigned understands that the processing time required by the City may exceed the time
limits, therefore the undersigned agrees to extend the time limits for Planning Commission and
City Council action and fully concurs with any extensions of time up to one year from the date
the application was accepted as complete to properly review all of the applications.
Date
i
' I ! .'
I J
Lance Waite, Lamco'Housing, Inc. . . Applicant
Name (Print) Relationship to Application
(Property Owner-Agent)
FRM0037 2/96
JA00HENTHORN & ASSOCI>fes
5431 Avenida Encinas • Suite J
Carlsbad, California 92008
Fax (619) 438-0981
(619) 438-4090
September 18, 1997
Mike Grim
City of Carlsbad
Planning Department
2075 Las Palmas Drive
Carlsbad, CA 92009-1576
Subject: Lohf Property - City Subdivision Submittal
Dear Mike:
The following items are submitted for your review and distribution:
Submittal Items
# of Copies
Or Sets
Land Use Review Application 1
Location Map 1
Environmental Impact Assessment 1
Public Facilities Agreement lorig/lcopy
Disclosure Statement 1
Title Insurance Report 3
School District Letter 1
Statement of Agreement to Waive TM Time Limits 1
Project Description/Explanation 1
Preliminary Soils/Geologic Report by Pacific Soils Engineering 2
Biological Resources Report and Impact Analysis by Dudek & Assoc. 2
Paleontological Resources Report by Thomas Demere 2
Archeological Report by RECON 2
Zone Change and Local Coastal Plan Amendment Map 1
Coastal Development Supplemental Application 1
Photographs of Property 1
Submittal Check w/Memo 1
Tentative Map 10
Hillside Development Permit/Constraints Map (W/Slope Analysis & Profiles) 5
Landscape Plan 10
Sincerely,
Melissa K. Allen
encl.
cc: File
Scot Sandstrom, Western Pacific Housing
C:\MSOffice\Templates\water.dot
-1-
ft)HF PROPERTY
ZONE CHANGE AND LOCAL COASTAL
PLAN AMENDMENT MAP
# RLM
• L-C
A AGRIC.
# RLM
• L-C
A VAC.
* RLM
• L-C
A VAC.
~1 * RLM
• R-1
A VAC.
* RLM
• R-1
A VAC.
* RLM/RM
• L-C
A WC.
* RLM/RM
•i r*
i * RLM/RM
• L-C
A RES-1-SFD
• i * RLM/RM
\ * L~C
\l A RES-1-SR
A_i_ '
O R-1 -7500
A RES.-1-SFD
PROJECT
SITE
* RLM/RM
• L-C
O R-1 -7500
A RES.-2-SFD
\
^-
-,. .,..,
• L-C
A WC.
\%.
>,
RLM/OS
• L-C
A we.
RLM/OS
• R-1-Q/OS
A SF SUBDIVISION
(ZONE 6)• RP-Q
A VAC./PARKING
(ZONE 6)
LEGEND KEY
GENERAL RLM RESIDENTIAL LOW-MEDIUM
PLAN RM RESIDENTIAL MEDIUM
DESIGNATION E ELEMENTARY
LAND VAC. VACANT
USE SF SINGLE FAMILY
MF MULTI FAMILY
RES. RESIDENTIAL
A GRIC. A GRICUL TURAL
ZONING R-1 ONE FAMILY RESIDENTIAL ZONE
RD-M RESIDENTIAL DENSITY MULTIPLE ZONE
L-C LIMITED CONTROL
R-P RESIDENTIAL PROFESSIONAL
0 QUALIFIED DEVELOPMENT OVERLAY ZONE
0-S OPEN SPACE
P-C PLANNED COMMUNITY
O
A
EXISTING GENERAL PLAN AND LOCAL
COASTAL PLAN LAND USE DESIGNATION
EXISTING ZONING
PROPOSED ZONING
EXISTING LAND USE
NORTH
1"=500'
TO:
FROM:
DATE:
JACK HENTHORN & ASSOCIATES
MEMORANDUM
SCOT SANDSTROM
MELISSA ALLEN
09/12/97
SUBJECT: LOHF - SUBMITTAL
REQUIRED SUBMITTAL FEES:
$ FEE $ LOT $ TOTAL
COASTAL DEVELOPMENT PERMIT
5 Unit/Lot Subdivision or more
ENVIRONMENTAL IMPACT ASSESSMENT
HILLSIDE DEVELOPMENT PERMIT
•/ LOCAL COASTAL PROGRAM AMENDMENT
Minor
NOTICE FEE
Deposit - Discretionary
PUBLIC FACILITIES FEE AGREEMENT
'TENTATIVE TRACT MAP - RESIDENTIAL
Major Subdivision, 50 or more Lots
ZONE CHANGE
25.1 acres or more
1,000 + 30/lot(83) = 3,490
220 220
400 400
1,700
500
50
1,700
500
50
7,500 + 25/lot(>50) = 8,325
2,175 2,175
TOTAL $ 16,860
C:\WINWORD\Lohf\Submtl Fees Memo.doc
JACK HENTHORN & ASSOCIATES • 5431 Avenida Encinas • Suite J • Carlsbad, CA 92008 • PH:(760) 438-4090 FAX:(760) 438-0981
CIRCULATION EXHIBIT
LOHF PROPERTY
CITY OF CARLSBAD, CALIFORNIA
HUNSAKER
& ASSOCIATES
I A N DltCQ. INC
FUNWJC WOT Humvktm St S**t JOO
ENGNSSNG S*n fteya, Ci 97171
SURVt^NC PHIbNKSMSOO • Hf(b19)55»-14M
Date: 1-15-99 W.O. 1751-13
Pacific
Ocean
VICINITY MAP
-^-/^---*--
Photo View Exhibit
EIVED
SEP 1 8 1997
CITY OF CARLSBAD
PLANNING
PRELIMINARY REVIEW APPLICATION
PROJECT NAME: LOHF PROPERTY
APPLICANT NAME: dba Western Pacific Housing, for Lamco Housinc
MAILING.ADDRESS: 2385 Camino Vida Roble suite 107 Carlsbad
PHONE NUMBER:619-929-1600 92009
PROJECT ASSESSOR'S PARCEL NUMBER(S) (APN):_215-050-59.18
, Inc
DESCRIPTION OF PROPOSAL (ADD ATTACHMENT IF NECESSARY):
Development of Single Family Dwelling units in Local
Facility Management Zone 21.
WOULD YOU LIKE TO ORALLY PRESENT YOUR PROPOSAL TO YOUR ASSIGNED
STAFF PLANNER/ENGINEER? YES NO
El D
PLEASE LIST THE NAMES OF ALL STAFF MEMBERS YOU HAVE PREVIOUSLY
SPOKEN TO REGARDING THIS PROJECT. IF NONE, PLEASE SO STATE.
nnn Rideoufc Mi ICP Hrim
^^^?^§^^^^»^^ffl^s^^^^^^^
FOR CITY USE ONLY
PROJECT NUMBER: ?
FEE REQUIRED/DATE FEE
— rjOfOfeC.RECEIPT NO.: O 1 CH ,2
RECEIVED BY: <JjBu>("-
^^^^^^^^^^^^U@l^^^^^@^K^^^^I^ffiW^^|^p&^^^^^^^j^^^^
^^ qi .-2>^
PAID: ^"20 X r^-l^ -T]) ^
FRM0025 3/96 PAGE 3 of 3
i / <; /' V it'' I ~3jy--v<<'iC/O'«^*---•"•• -/o CiO^i^ A CITY OF CARLSBAD
" '" 1200 CARLSBADWlLLAGE DRIVE CARLSBAD,liFORNIA 92008
/ >
REC'D FROM I A I A.
434-2867
ACCOUNT NO.
fl y/ ~ <
( - r&\. nu-CT
RECEIPT NO. 39015
DESCRIPTION
Pi2£' 9-7.3^
^79 06/M/W
NOT VALID UNLESS VALIDATED BY TOTAL
AMOUNT
/D-O (){)
<J001 <& 02
c-i^?r ;j?K4;)
/^-O 0^"
I Printed on recycled paper.CASH REGISTER
PRELIMINARY REVIEW APPLICATION
PROJECT NAME: ff/l/JflP.2) / /.///2>/f
APPLICANT NAME:
MAILING ADDRESS:
PHONE NUMBER: ~7
/S//7
PROJECT ASSESSOR'S PARCEL NUMBER(S) (APNV
DESCRIPTION OF PROPOSAL (ADD ATTACHMENT IF NECESSARY):
7/
WOULD YOU LIKE TO ORALLY PRESENT YOUR PROPOSAL TO YOUR ASSIGNED
STAFF PLANNER/ENGINEER? YES NO
D B^
PLEASE LIST THE NAMES OF ALL STAFF MEMBERS YOU HAVE PREVIOUSLY
SPOKEN TO REGARDING THIS PROJECT. IF NONE, PLEASE SO STATE.
FOR CITY USE ONLY
PROJECT NUMBER:70
FEE REQUIRED/DATE FEE PAID:
RECEIPT NO.:
RECEIVED BY:
FRM0025 3/96 PAGE 3 of 3
CITY (g.F CARLSBAD
1200 CARLSBADWILLAGE DRIVE CARLSBAD, HfLIFORNIA 92008
434-2867
ftl
REC'D FROM K ^4-DATE
ACCOUNT NO.
C - i4 r/;«j/
RECEIPT NO. 3T075
DESCRIPTION
Pi-ll '-/'I -61
NOT VALID UNLESS VALIDATED BY TOTAL
AMOUNT
$ IJfl drf
>'"'"•
C-PRMT 12') «00
&> / -P{) &)
I Printed on recycled paper.CASH REGISTER