HomeMy WebLinkAboutCUP 00-301A; Starvin' Marvin's; Conditional Use Permit (CUP)• City of (iarlsbaH
DISCLOSURE STATEMENT
APPUCANTS STATEMENT OF DISCLOSURE OF CERTAIN OWNERSHIP INTERESTS ON ALL APPUCATIONS
WHICH WILL REQUIRE DISCRETIONARY ACTION ON THE PART OF THE CITY COUNCIL OR ANY APPOINTED
BOARD, COMMISSION Ofl COMMrTTEE.
(Please Print)
The fcllowing information must be disclosed:
1. Applicant
List the names and addresses of all persons having a financiai interest in the application.
Owner
Ust 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 ar
addresses of all individuals owning more than 10% of the shares in the corporation or owning any partnersh^
interest in the partnership.
If any person identified pursuant to (1) or (2) above is a non-profit organization or a trust, list the names anc
addresses of any person sen/ing as officer or director of the non-profit organization or as trustee or beneficiar
of the trust.
(Over)
Disdosure Statement ' Page 2
5. Have you had more than $250 worth of business transacted with any member of City staff. Scares
Commissions, Committees and Council within the past twelve months?
Yes No If yes, please indicate person(s)
Person is defined as: 'Any individual, firm, copartnership, joint venture, association, social club, fraternal
organization, corporation, estate, trust, receiver, syndicate, this and any other county, city and counfy, cify
municipality, district or other political subdivision, or any other group or combination acting as a unit.'
(NOTE: Attach additional pages as necessary.)
Signature of-Own$r/date Signature of applicant/date
Print or type rfame of owner Print or type name of applicant
Carlsbad Journal
Decreed A Legal Newspaper by the Superior Court of San Diego County
Mail all correspondence regarding public notice advertising to
W.C.C.N. Inc. P.O. Box 230878, Encinitas, CA 92023-0878 (619) 753-6543
Proof of Publication
STATE OF CALIFORNIA, ss.
COUNTY OFSAN DIEGO,
I am a citizen of the United States and a resident of the county aforesaid;
I am over the age of eighteen years, and not a party to or interested in the above entitled matter.
I am principal clerk of the printer of the Carlsbad Joumal, a newspaper of general circulation,
published v^eekly in the City ofCarlsbad, County of San Diego, State of California, and which newspaper
is pubUshed for the dissemination of local news and intelligence of a general character, and which
newspaper at all times herein mentioned had and still has a bona fide subscription list of paying
subscribers, and which newspaper has been established, printed and published at regular intervals in the
said City of Oceanside, County of San Diego, State of California, for a period exceeding one year next
_ preceding the date of publication of the
notice hereinafter referred to; and that the
notice of which the annexed is a printed
copy, has been published in each regular
and entire issue of said newspaper and not
in any supplement thereof on the follow-
ing dates, to-wit:
NOTICE OF
PUBLIC HEARING
NOTICE IS HEREBY GIVEN that the Plan-
ning Coramission ofthe City ofCarlsbad will
hold a public hearing at the Council Cham-
bers, 1200 Carlsbad Village Drive, Carlsbad,
California, at 6:00 p.m. on Wednesday, March
18, 1992, to consider approval of amending
and extending six existing Conditional Use
Permits to remove the restriction prohibiting
tables and chairs within six delicatessens
generally located within the P-M zone and
more particularly described as:
Parcel 19 of Rancho Agua Hedionda, Lot H,
according to Map No. 823, Lots 8 and 13 of
Carlsbad Tract 81-10, Unit No. 1, according to
Map No. 10330, Lots 2 and 7 ofCarlsbad Tract
79-1, according to map No. 9389, Lot 2 ofCarls-
bad Tract 79-14, according to Map No. 9744,
and Parcel 1 as shown on Page 13051 of Parcel
Maps filed December 9, 1983, all within the
City ofCarlsbad, County of San Diego, State of
California. ' •• •
Those persons wishing to speak on this pro-
posal are cordially invited to attend the pub-
lic hearing. Copies ofthe staff report will be
available on and atter March U, 1992. Ifyou
have any questions, please call Mike Grim in
the Planning Department at 438-1161, ext.
4499.
Ifyou challenge the Conditional Use Permit
Amendments or Extensions in court, you may
be limited to raising only those issues you or
someone else raised at the public hearing de-
scribed in this notice or in written correspon-
dence delivered to the City of Carlsbad at or
prior to the public hearing.
Case File: CUP 215(B)xl/CUP 226(B)xl/
CUP 250(B)xl/CUP 270{A)xl/
CUP 301(A)xl/CUP 88-19(A)xl
Case Name: Industrial Deli Seating
CITY OF CARLSBAD
PLANNING COMMISSION
O 6878: March 5,1992
Cit) d Huisiii
CIP 21S<B)»1/CtJP 225(B|«1/
OJP 250(a)il/CU" 270(A)xt/
March 05 1992_
19
19
19
19
I certify under penalty of perjury that tiie
foregoing is true and correct. Executed at
Carlsbad, County of San Diego, StiMe of
California on_ the Sth
day of_ March 1992
Clerk of the Printer
NOTICE OF PUBLIC HEARINC
NOTICE IS HEREBY GIVEN that the Planning Conimission of the City of Carlsbad will hold
a public hearing at the Council Chambers, 1200 Carlsbad Village Drive, Carlsbad,
Califomia, at 6:00 p.m. on Wednesday, March 18,1992, to consider approval of amending
and extending six existing Conditional Use Permits to remove the restriction prohibiting
tables and chairs within six delicatessens generally located within the P-M zone and more
particularly described as:
Parcel 19 of Rancho Agua Hedionda, Lot H, according to Map No. 823, Lots
8 and 13 of Carlsbad Tract 81-10, Unit No. 1, according to Map No. 10330,
Lots 2 and 7 of Carlsbad Tract 79-1, according to Map No. 9389, Lot 2 of
Carlsbad Tract 79-14, according to Map No 9744, and Parcel 1 as shown on
Page 13051 of Parcel Maps filed December 9, 1983, all within the City of
Carlsbad, Coimty of San Diego, State of Califomia.
Those persons wishing to speak on this proposal are cordially invited to attend the public
hearing. Copies of the staff report will be available on and after March 11, 1992. If you
have any questions, please call Mike Grim in the Planning Department at 438-1161, ext.
4499.
If you challenge the Conditional Use Permit Amendments or Extensions in court, you may
be limited to raising only those issues you or someone else raised at the public hearing
described in this notice or in written correspondence delivered to the City of Carlsbad at
or prior to the public hearing.
CASE FILE: CUP 215(B)xl/CUP 226(B)xl/CUP 250(B)xl/CUP 270(A)xl/
CUP 301(A)xl/CUP 88-19(A)xl
CASE NAME: INDUSTRIAL DELI SEATING
PUBLISH: MARCH 5, 1992
CITY OF CARLSBAD
PLANNING COMMISSION
O LOCATION OF DBJ
i.
City of Garisiuui
CUP 215(B)x1/CUP 226(B)x1/ CUP 250(B)x1/CUP 270(A)x1/
INDUSTRIAL DELI SEATING CUP 301(A)x1/CUP 88-19(A)x1
Notice of Detennination ^ni 920212
To: Office of Planmng and Research
1400 Tenth Street, Room 121
Sacramento, CA 95814
From: Cily of Carlsbad
Planning Department
2075 Las Palmas Dr.
Carlsbad, CA 92009
Coimty Clerk
County of San Diego
Atm: Mail Drop C-11
220 West Broadway
San Diego, CA 92101
IF Annette.!. Evans, Clerk E) (619) 438-1161
MAR 2 5 1992
BY
ProjectNo.: CUP 301(A)
FiUng of Notice of Detennination in compliance with Section 21108 or 21152 of the Public Resources Code.
Starvin' Marvin's (Industrial Deli Seating)
Project Title
Citv of Carlsbad. Mike Grim (619)438-1161x4499
State Qeaiinghouse Number Lead Agency
(If submitted to Clearinghouse) Contact Person
Area Code/Telephone/Extension
5431 Avenida Encinas. Citv of Carlsbad, Countv of San Diego
Project Location (include county)
Project E)escnption: Amendment to existing Conditional Use Pennit to allow tables and chairs within
the deli.
This is to advise that the Cily of Carlsbad has approved the above described project on March 18,1992 and
has made the following determinations regarding the above described project.
1. The project will not have a significant effect on the environment.
2. This project was reviewed previously and a Negative Declaration was prepared pursuant to the
provisions of CEQA.
Mitigation measures were not made a condition of the approval of the project.
A statement of Overriding Considerations was not adopted for this project
Findings were made pursuant to the provisions of CEQA.
This is to certify that the final Negative Declaration with comments and responses and record of project
approval are available to the General Public at THE CITY OF CARLSBAD.
yW'??.
' Dafe
3.
4.
5.
PLANNING DIRECTOR
MICHAEL J. HOLZMILtER TITLE
Date received for filing at OPRjc »ILXD I¥ THI 0»FICS OP THE OOUNTY CLBRK,
SAN DIBGO COUHTY o* MAR 2 5 Wl
POSTED MAR 2 5 1992 RmMnvi.T. y« 2 4 mT
IVBTURinSD TO AOBHCT OH
DBPUTT Revised Uctc jcr 1989
MG:km
CALAINIA DEPARTMENT OF FISH ANAAME
PO BOX 944209
SACRAMENTO CA 94244-2090
CERTIFICATE OF FEE EXEMPTION
De Minimis Impact Finding
Project Title/Location (indude cotmty):
CUP 301 (A) - Starvin' Marvin's (Industrial Deh Seating)
5431 Avenida Encinas, City of Carlsbad, Coimty of San Diego
Name and Addiess of ^^plicant:
Starvin' Marvin's Deli
5431 Avenida Encinas, Carlsbad, CA 92008
Project Description:
Amendment to existing Conditional Use Permit to allow tables and chairs within the deli.
Findings of Exemption (attach as necessaiy):
1. The City of Carisbad Plaiming IDepartment has completed an Environmental Initial
Study for the above referenced propeity, including evaluation of the proposed
project's potential for adverse environmental impacts on fish and wildlife resources.
2. Based on the completed Environmental Initial Study, the City of Carisbad Planning
Department finds there is no evidence before the City of Carlsbad that the proposal
will have potential for an adverse ejOfect on wild life resources or the liabitat upon
which the wildlife depends.
3. The City of Carlsbad has on the basis of substantial evidence, rebutted the
presumption of adverse effect contained in AB 3158 Chapter 1706 Section 753.5(d).
Certification:
I hereby certify that the lead agency has made the above findings of fact and that
based on the initial study and hearing record the project will not individually or
cimiulatively have an adverse effect on wildlife resources, as defined in Section 711.2 of
the Fish and Game Code.
MICHAEL Jr'HOLZMILLER
Title: Planning Director
Lead Agency: City of Carlsbad
Date: March 20. 1992
MG:km
Section 711.4, Fish and Game Code
DFG:12/90
STATE OF CALIFORNIA-THE RESOURCES AGENCY
DEPARTMENT OMSH AND GAME- 6109
EtlVIRONM^^L FILING FEE CASH RECEIPT
DFG 753.5a (6-91)
Lead Agency: fiZtL y &CA.>W^-r^ Date: ^^6r/?A
County/State Agency of ping: (I yW£^ 'i^lC(2^^^ Document No.: ^olO^/^
Project Title: /6:iaAy'-<4,^' p^^iA^-'^^^LJi f 9r~^JLu-^t^jC^ K^^' /UjlJtl.:^ J
Project Applicant Name: Phone Number: U
Project Applicant Address:
Project Applicant {ctieck appropriate box): Local Public Agency Q School District Q Other Special District | |
State Agency Q Private Entity
CHECK APPLICABLE FEES:
Environmental Impact Report $850.00 $
Negative Declaration $1,250.00 $
Application Fee Water Diversion (State Water Resources (Control Board Only) $850.00 $
Projects Subject to Certified Regulatory Programs $850.00 $
County Administrative Fee $25.00 $
/^ Project that is exempt from fees
TOTAL RECEIVED $ ^
Signature andjttle of person receiving payment: ^(^^>
•
Citv of Carlsbad
Planning Departnnent
NOTICE OF EXPIRATION
December 5, 1996
San-Gal Trust
c/o Philip Gildred Jr.
550 W. C Street #1820
San Diego CA 92101
SUBJECT: CUP 301(A) - STARVIN' MARVIN'S
In a recent audit of our records, we found that CUP 301(A) - STARVIN' MARVIN'S will
expire on March 18, 1997. Should you, the property owner, require an extension of
this permit, please send the following:
^ Written request for an extension;
^ Completed Disclosure Statement (enclosed); and
^ A check in the amount of $900 ($555 for non-profit organizations). A
$500 deposit for noticing is included. Unused noticing monies will be
refunded upon completion of processing the request for an extension.
Send the required documents and warrants to:
Brandi King
City of Carlsbad
Planning Department
2075 Las Palmas Drive
Carlsbad CA 92009
Your request for an extension must be received before December 19, 1996, to allow
adequate time to process your application and schedule a hearing before the Planning
Commission. If you do not request an extension by this date, the permit will be
considered invalid and to continue operating, you will be required to submit an
application for a new permit, along with a check in the amount of $3,000 ($620 for
non-profit organizations).
Should you have any questions, please contact your staff planner, Mike Grim, in the
Planning Department at (619) 438-1161, extension 4499.
Sincerely,
BRAIMDIH<ING
Planning Department
c: File Copy
Staff Planner
2075 Las Palmas Dr • Carlsbad, CA 92009-1576 • (619) 438-1161 • FAX (619) 438-0894 ^
GILDRED DEVELOPMENT COMPANY 550 WEST C STREET, SUITE 1820
SAN DIEGO, CALIFORNIA 92 101-3509
TELEPHONE (619) 232-6361
FACSIMILE (6 1 9) 696-099 1
December 12, 1996
City of Carlsbad
Brandi King
2075 Las Palmas Drive
Carlsbad, CA 92009-1576
RE: CUP 301A
Please cancel the above referenced CUP. The tenant has vacated.
Sincerely,
William H. Adair
Executive Vice President
WHA:bk
STAFF REPORT ® DATE: MARCH 18, 1992
TO: PLANNING COMMISSION
FROM: PLANNING DEPARTMENT
SUBJECT: CUP 215fB)/aJP 226(B)/CUP 250(B)/CUP 270fA)/CUP 301fA)/CUP 88-
19(A) - INDUSTRIAL nPT.r •<;FATTNn . Request for amendments to six
existing Conditional Use Permits to remove the restriction prohibiting tables
and chairs within six delicatessens in the P-M zone.
I. RECOMMENDATION
That the Planning Commission ADOPT Planning Commission Resolution No's. 3365,
3366, 3367, 3368, 3369, and 3370, APPROVING CUP 215(B), CUP 226(B), CUP
250(B), CUP 270(A), CUP 301(A), and CUP 88-19(A), based on the findings and
subject to the conditions contained therein.
n. PROJECT DESCRIPTION AND BACKGROUND
This project is a City-initiated request to amend six existing Conditional Use Permits for
deUcatessens in the P-M zone to allow seating for the consumption of food on the premises.
The six delicatessens were allowed by CUP between 1982 and 1989 and have been
operating without incident since opening. The approving resolutions for these conditional
uses state that no tables or chairs for the consxmiption of food on the premises are allowed.
This condition was intended to avoid potential parkiAg impacts that were anticipated if
seating was allowed, likening the industrial deUcatessens to restaurants.
Since these delicatessens have been operating, staff has monitored their operations,
including parking impacts, and has found that the original assessment of parking
requirements for industrial delicatessens was not accurate. Based upon numerous visits to
the variety of delicatessens within the Planned Industrial area, staff fotmd that the
delicatessens with seating actually encouraged walk-in patronage more than their "take-out
only" coimterparts. The patron who could eat at the delicatessen was more apt to walk,
whereas the take-out patron was more apt to drive up, purchase their food, and eat in their
vehicle or drive away.
CUP 215(B)/CUP 226(B)/CUP 250(B)/CUP 270(A)/CUP 301(A)/
CUP 88 19(A) - INDUSTRL\L DELI SEATING
MARCH 18, 1992
PAGE 2
The limited seating provided by deUcatessens in these areas is used on a more casual basis
than restaurant seating. Parking deficiencies do not result from the addition of limited
seating to delis in such industrial areas because patronage tends to be limited to employees
of the surrounding uses and more food is sold on a "take-out" basis. Given this newly
evaluated situation, staff began pursuing a comprehensive amendment to the pertinent
conditional use permits to allow a limited number of seating for the consumption of food
withm the deUcatessen. Since this action is a Conditional Use Permit Amendment, the date
of expiration of all six deUcatessens is being amended to five years from the date of this
approval, or March 18, 1997.
nr. ANALYSIS
1. Given the requested amendments, can the four findings required for a Conditional
Use Permit still be inade? Namely,
a) That each deU is necessary or desirable for the development of the
community, is essentiaUy in harmony with the various elements and
objectives of the general Plan, and is not detrimental to existing uses or to
uses specifically pemiitted in the zone in which the deU is located;
b) That the site for each deU is adequate in size and shape to accommodate the
use;
c) That aU of the yards, setbacks, walls fences, landscaping, and other features
necessary to adjust each deU to existing or permitted future uses in the
neighborhood is provided and maintained;
d) That the street system serving each deU is adequate to properly handle aU
traffic generated by each deU.
DISCUSSION
1. DesirabiUtv and Harmony of Use
The deUcatessens in the industrial area serve a large limchtime cUentele, and provide a
needed service to an area void of altemative eating establishments. AUowing tables and
chairs gives the walking patron the opporttmity to eat at the deUcatessen, providing
convenience to the ctistomers. This is consistent with one of the goals of the Land Use
element of the General Plan, which is to "generate the development of commercial
enterprises that support local industries...". The Circulation element requires that
commercial development provide adequate parking. As mentioned previously, tables and
chairs in a deUcatessen actuaUy promote walk-in patronage, assuring adequate parking and
CUP 215(B)/CUP 226(B)/CUP 250(B)/CUP 270(A)/CUP 301(A)/
CUP 88 19(A) - INDUSTRIAL DEU SEATING
MARCH 18, 1992
PAGE 3
eliminating any detrimental effects to surrounding uses. Therefore, by providing food
service to the large employment base of the industrial area while not impacting parking,
the deUcatessens remain in harmony with the General Plan and are not detrimental to
existing or future uses.
2. Adequacy of Site in Size and Shape
Based upon several field investigations, industrial deUcatessens with seating for food
consumption generate less automobile traffic than those without seating, primarily because
of the abiUty of the customer to walk in and stay to eat. The six deUcatessens proposed
for amendments have operated with tables and chairs for some time and no adverse
impacts to parking have resulted. Since the proposed amendments do not require
expansion or further improvement of any site, the sites are stiU adequate in size and shape
to accommodate the deUcatessens.
3. Features Necessarv to Adjust Use
As discussed above, the deUcatessens are currently operating in a manner compatible with
the surrounding uses. Since the proposed amendments do not necessitate any additional
improvements, aU yards, setbacks, waUs, fences, landscaping, and other features necessary
to continue to adjust the deUcatessens to existing and future uses in the neighborhood have
been provided and maintained.
4. Adequacy of Street Svstem
Since the aUowance of tables and chairs promotes pedestrian traffic, the proposed
amendments should maintain the existing traffic generation rates of the deUcatessens. The
existing street systems serving the deUcatessens currently operate above standards and wiU
continue to be adequate to accommodate aU traffic generated by the deUcatessens.
IV. APPLICABnJTY
This amendment proposes to aUow limited seating with delis only in the PM Zone because
of the special use characteristics which apply to these areas (namely tendency for patrons
to be employees within walking distance; high volume of "take-away food sales).
V. ENVIRONMENTAL REVIEW
Since the proposed amendments do not significantly alter the originaUy approved uses or
their impacts, the Planning Director has detennined that the environmental effects of the
projects have already been considered in conjunction with previously certified
environmental documents. A Notice of Prior Environmental CompUance, therefore, wiU be
issued for aU Conditional Use Permit amendments.
CUP 215(B)/CUP 226(B)/CUP 250(B)/CUP 270(A)/CUP 301(A)/CUP 88 19(A)
INDUSTRLU DELI SEATING
MARCH 18, 1992
PAGE 4
SUMMARY
This amendment would only aUow limited seating for delis in the PM Zone. Considering
that aU findings required for a Conditional Use Permit can stiU be made for each
deUcatessen, staff reconunends that the Planning Commission approve the requested
amendments conditionaUy aUowing tables and chairs within delis in the planned industrial
area.
ATTACHMENTS
1. Planning Conunission Resolution No. 3365
2. Planning Commission Resolution No. 3366
3. Planning Commission Resolution No. 3367
4. Plaiming Commission Resolution No. 3368
5. Planning Commission Resolution No. 3369
6. Plaiming Commission Resolution No. 3370
7. Location Maps
8. Disclosure Statements.
February 11, 1992
MG:kin
/
Cit} of CirliM
VAN VOORhflS/SHORTER CUP 215(B)
BARBIE'S LUNCH DEPOT CUP 226(B)
/
LLOYD KIM
Cit? tf iiMM
CUP 250(B)
City of Carislai
CHOI SANDWICH SHOP CUP 270(A)
Git) of Gariskai
MISSION WEST DELI CUP 88-19(A)
^^^^^ ^* City of Cadsbad
DISCLOSURE STATEMENT
APPUCANTS STATEMENT OF DISCLOSURE OF CERTAJN OWNERSHIP INTERESTS ON AU. APPUCATIONS
WHICH WIU. REQUIRE DISCRETIONARY ACTION ON TVIE PART OF THE CITY COUNCIL OR ANY APPQiNTPn
BOARD. COMMISSION OR COMMITTgE.
• Please Print)
The following information must b« disclostd:
1 Aooliont
Ust th« namM and addrtsMS of ail parsons having a financiai intarast in tha application.
2. Qwny
List tlia namas and addrassaf of all parsons having any ownarship intarast in tha proparty involved. I and addrassaf
ThloyvyA^ uJ. ^o^^-tEcki
3. If any parson idantiflad pursuant to (1) or (2) abova it • corporation or pailnarship. list tha namas
addraasaa of aii individualt owning mora than 10% of tha sharat in tha corporation or owning any partners
intarast in tha partnarship.
If any parson idantiflad pursuant to (l) or (2) abova ia a non-profK organization or a tnjat list tha names
addraaaaa of any parson sarving aa offlcar or diractor of tha non^oflt organization or aa trustaa or banefic
of tha trust
Oisdosura Statamant Page 2
Have you had mora than S250 worth of businass transacted with any mambar of City staff 3ca'
Commissions, Committaas and Council within tha past twaiva months?
Yes No _2L ^ yM- ?'•«»• indicate parson(s)
Person is defined as: 'Any individual, firm, copartnership, joint venture, association, social club, fraternal
organizauon. corporation, estate, trust rececver, syndicate, this and arry other county, city and county, CT/
muntcipaiity, distna or othar poiiticai subdivision, or any other group or combination acting as a unit.'
(NOTE: Attach additional pagaa as nacassary.)
Signature of Ovirtiar/data Signature of applicanVdata
Tl-loAl /?s . Koy> J. <11
Print or typa nama of ownar Print or typa nama of applicant
C-vp 2^2^\ ^ City of (Sarlsbari
DISCLOSURE STATEMENT
APPUCANTS STATEMENT OF DISCLOSURE OF CERTAiN OWNERSHIP INTERESTS ON Aa APPUCATIONS
WHICH WIU. REQUIRE DISCRETIONARY ACTION ON THE PART OF THE CITY COUNCIL OR ANY APPOINTS"!
BOARD. COMMISSION OR COMMirTEE.
fPiease Print)
The following information must ba disctosad:
1 Aoolicant
UsLtha namas and addrassas of ail parsona having a financial intaraat in tha application.
2. Ownar
List the namas and addraasaa of all parsons having any ownarship intarast in tha property involved.
If any parson idantiflad pursuant to (1) or (2) abova ia a corporation or partnarship, list tha names a
addraasaa of all individualt owning mora than 10% of tha sharaa in tha corporation or owning any partners
intaraat in tha partnarship.
If any parson idantiflad pursuant to (1) or (2) abova ia a non-pro(R organization or a tnjat, list tha names :
addraaaaa of any parson sarving at oflicar or diractor of tha non^oftt organization or aa tnjstsa or banefic;
of tha tnjat.
(Over)
Oisdosura Statamant Page 2
5 Have you had mora than S250 worth of businass transacted with any mambar of City staff, 3c a'
Commissions, Committaaa and Counal within tha past twaiva montha?
Yes No If yas, plaaaa indicata parson(s)
Person is defined aa: 'Any individuat, firm, copaitnarship, joint venture, association, social club, fraternal
organization, corporation, estate, trust receiver, syndicate, thia and any other ccunty, city arn) county, CT/
municipality, distnct or othar political subdivision, or arry other group or combinatic ^ acting as a untt.'
(NOTE: Attach additional pages as nacassary.)
Signature of Ownar/data n Signature of appiicant/data
Print or typa nama of ownar Print or typa nama of appiicant
City of Carisbad
DISCLOSURE STATEMENT
APPUCANTS STATEMENT OF DISCLOSURE OF CERTAiN OWNERSHIP INTERESTS ON ALL APPUCATIONS
WHICH WILL REQUIRE DISCRETIONARY ACTION ON THE PART OF THE CITY COUNCIL OR ANY APPQiNTPa
BOARD. COMMISSION OR COMMfTTEE.
(Please Print)
The following information must ba disclosed:
1 AoollcarTt
t tha namaa and addraasaa of all parsons having a finandal intaraat in tha application.
List tha namas and addrassas of ali parsons having any ownarship interest in tha property involved.
3. If any parson idantiflad pursuant to (1) or (2) abova ia a corporation or partnarship, list tha names ar
addraasaa of all individualt owning mora tt>an 10% of tha sharaa in tha corporation or owning any partnersr
intaraat in tha partnarship.
If any parson idantiflad pursuant to (1) or (2) abovt it a non-profit organization or a tnjat list tha names a
addraaaaa of any paraon atr^ at oflicar or diractor of tha non-profit organization or aa truataa or beneficu-
of thatmat
fOver)
Oisdosura Statamant Page ,
5 Have you had mora than $250 worth of businass transacted with any mambar of City staff. 3ca.-
Commissions. Committaas and Councii within tha past twaiva montina?
Yes No If yaa, plaaaa indicata person(s)
Person is defined as: 'Any individual, firm, copartnership, joint venture, association, social club, fraternal
organization, corporation, estate, trusL receiver, syndicate, this and any other county, ctty and county, CT/
muntcipaiity, distria or otiw political sutxiivision, or any other group or combination acting as a unit.*
^NOTE: Attach additional pagaa as nacassary.)
1
ignature of Ownar/data Signature of appiicant/data
Print or typa nama of ownar Print or typa nama of applicant
City Of Carl^H
DISCLOSURE STATEMENT
APPUCANTS STATEMENT OF DISCLOSURE OF CERTAIN OWNERSHIP INTERESTS ON ALL APPUCATIONS
WHICH WIU REQUIRE DISCRETIONARY ACTION ON TViE PART OF THE CITY COUNCIL OR ANY APPOiN--n BOARD, COMMISSION OR COMMITTEE. v. P. ,
'please Pnnt)
'he fcllowing information must ba disclosed:
1 Aooiicant
Ls^a jT^ma^^d^drassas of ail parsons having a finandal interest in tha application.
Ownar
Ust tha namas and addrassas of all parsons having any ownarship interest in the property mvcived.
3. If any parson idantiflad pursuant to (1) or (2) abova ia a corporation or partnarship, list tha names
addressaa of all individualt owning mora ttian 10% of tt^a sharaa in tiia corporation or owning any panners
interest in ttia partiwship.
If any parson idantiflad pursuant to (1) or (2) abova ia a non-profit organization or a ttuat. list ttia names
addraaaaa of any paraon aarving at offlcar or diractor of ttia non-profit organization or aa ttustea or banefic
of ttia trust
Oisdosura Statamant Page 2
3 Have you had more ttian S2S0 worth of businass ttansactad with any mambar of City staff Bea-
Commissions. Committaea and Counal wittiin ttia past twelve monttia?
Yes No It yea, plaaaa indicate person(s)
Person is defined as: 'Any individual, firm, copannership, joint venture, association, social club, fratemaj
organization, corporation, estate, trust receiver, syndicate, this arxj any other county, city arnl county, cr/
municipality, district or other political subdivts on, or any other group or combination acting as a unit.'
(NOTS: Attach additional pagaa as nec. ..ary.)
Sigfialure 6ji Ownar/d^ Signature of applicant/date
Print or typa nama of ownar Print or typa nama of appiicant
C(JFJoi(A) • City of Carlsbari
DISCLOSURE STATEMENT
APPUCANTS STATEMEhrr OF DISCLOSURE OF CERTAIN OWNERSHIP INTERESTS ON ALL APPUCATCNS
WHICH WIU. REQUIRE DISCRETIONARY ACTION ON THE PART OF THE CITY COUNCIL OR ANY APPCiN'eT
BOARD. COMMISSION OR COMMITTEE.
'Please Pnnt)
The fcllowing information must ba disclosed:
1 Apolicant
List ttie names and addrassas of all parsons having a financial interest in ttie application.
Ownar
Ust tha namas and addrassas of ail persons having any ownarship intsrest in ttie property involved.
If any person idantiflad purauant to (1) or (2) abova ia a corporation or parttiarship, list ttia names
addressaa of all individualt owning mora ttian 10% of ttia sharaa in ttia corporation or owning any panner;
interest in ttia parttiarship.
If any parson idantiflad pursuant to (1) or (2) abova ia a non-profit organization or a ttuat. list ttia names
addraaaaa of any paraon sarving at offlcar or diractor of ttia non-profit organization or aa ttustaa or banefic
of ttia ttuat
iQveri
Oisdosura Statamant Page 2
3 Have you. had more ttian S250 worth of business ttansactad witti any member of City staff. 3ca-
Commissions, Committees and Council wittiin ttia past twelve months?
Yes No It yes, plaaaa indicate person(s) ,
Person is defined as: 'Any individual, firm, cooartnership, joint venture, association, social ctuo. fratemai
organization, corporation, estate, trust receiver, syndicate, ttiis and any other county, city and county, cTy
municipality, distna or other political subdivision, or any other group or eomoination acting as a unit.'
(NOTE: Attach additional pagaa as necessary )
Signature of-Own^r/data Signatijra of applicanVdate
Print or typa hama of ownar Print or typa nama of applicant
Cltv of CarlsbaH
DISCLOSURE STATEMENT
APPUCANTS STATEMENT OF DISCLOSURE OF CERTAIN OWNERSHIP INTERESTS ON AU. APPUCATIONS
WHICH WILL REQUIRE DISCRETIONARY ACTION ON THE PART OF THE CITY COUNCIL OR ANY APPOINTED
BOARD. COMMISSION OR COMMITTEB.
fPlease Print)
The fcllowing information must ba disclosed:
1 Aooiicant
Ust the names and addresses of ail persons having a financial interest in ttie application.
y:^;r <JA ^r>i <^^^ '^X.r-y^
Ownar
Ust tha names and addrassas of ail parsons having any ownarship interest in ttie property involved.
MUAj A /A/
^•^v ( ^Ai..y 4^ 'Ti.OTf
3. If any person identifiad purauant to (1) or (2) abova ia a corporation or parttiarship, list ttie names a
addressaa of all individualt owning mora ttian 10% of ttia sharaa in ttia corporation or owning any panners
interest in ttia parttiarship.
If any parson idantiflad pursuant to (1) or (2) abova ia a non-profit organization or a ttuat. list ttie names s
addressaa of any paraon sarving at offlcar or diractor of ttia non-profit organization or aa ttustea or benefic:
of ttia ttuat
Oisdosura Statamant Page 2
Have you had mora ttian $250 wortti of businass ttansactad witti any member of City staff, 3ca'
Commissions, Committees and Councii within ttia past twelve months?
Yes No It yes, pleasa indicate person (s)
Person is defined as: 'Any individual, firm, copannership, joint venture, association, social club, fraternal
organization, corporation, estate, trust receiver, syndicate, ttiis and any other county, oty and ccunty. CT/
municipality, distria or other political subdivision, or any other group or combination acting as a unit.'
(NOTE: Attach additional pages as necessary.)
y^
Signature ature of Ownar/
/
r/data Signature of applicant/date
Print or typa nama of ownar Print or typa nama of appiicant