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Home My WebLink AboutCUP 250BX2; PALOMAR DELI; Conditional Use Permit (CUP)-CITY OF CARLSBAD -LAND USE REVIEW APPLICATION 1 I APPLICATIONS APPLIED FOR: (CHECK BOXES) (FOR DEPARTMENT (FOR DEPARTMENT USE ONLY) USE ONLY) □ Administrative Permit -2nd □ Planned Industrial Permit Dwelling Unit □ Administrative Variance □ Planning Commission Determination □ Coastal Development Permit □ Precise Development Plan (t(' Conditional Use Permit CUP.lSO B-4 □ Redevelopment Permit □ Condominium Permit □ Site Development Plan □ Environmental Impact □ Special Use Permit Assessment □ General Plan Amendment □ Specific Plan □ Hillside Development Permit □ +eAtati•.•e PaFsel Ma1:1 Obtain from Engineering Department □ Local Coastal Plan Amendment □ Tentative Tract Map □ Master Plan □ Variance □ Non-Residential Planned □ Zone Change Development □ Planned Development Permit □ List other applications not soecified 21 ASSESSOR PARCEL NO(S).: 3) PROJECT NAME: 4) BRIEF DESCRIPTION OF PROJECT: 5) OWNER NAME (Print or Type) 6) APPLICANT NAME (Print or Type) , . :rA-tMe~ ~. St.f 1wtA-43<J 1<..u Ro ?A-L-t> t'A,t\-~ ];) el. L_ I MAILING ADDRESS MAILING ADDRESS (,_. Ji.oS-W\ l MoS4--Avs:-C, l s-o y ~ ,2C> uJ DL CITY AND STATE ZIP TELEPHONE CITY AND STATE ZIP TELEPHONE v,~stJL (!_o.' 11.0 5'13,..:>1, <?Ai.J..~,8'1P (.{J 4/)00 1c.oj43"S'i1 I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I,. • J /J , / / } "" ~~ /I /IC, /01 IGNATURE DAT~ I 7) BRIEF LEGAL DESCRIPTION I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST O MUc._~_ ll /11, /~/ DATfl 1 NOTE: A PROPOSED PROJECT REQUIRING MULTIPLE APPLICATIONS BE A~[). MUST BE SUBMITTED PRIOR TO ·3:30 P.M. A PROPOSED PROJECT REQUIRING ONLY ONE APPLICATION BE 1FILED, MUST BE SUBMITTS),PRIOR TO 4:00 P.M. Form 16 -8) LOCATION OF PROJECT: ON THE (NORTH, SOUTH, EAST, WEST) BETWEEN (NAME OF STREET) STREET ADDRESS SIDE OF AND (NAME OF STREET) (NAME OF STREET) 9) LOCAL FACILITIES MANAGEMENT ZONE 10) PROPOSED NUMBER OF LOTS D 11) NUMBER OF EXISTING D 12) PROPOSED NUMBER OF RESIDENTIAL UNITS RESIDENTIAL UNITS 13) TYPE OF SUBDIVISION 16) PERCENTAGE OF PROPOSED PROJECT IN OPEN SPACE 19) GROSS SITE ACREAGE 22) EXISTING ZONING □ 14) PROPOSED IND OFFICE/ D 15) PROPOSED COMM SQUARE FOOTAGE SQUARE FOOTAGE □ 17) PROPOSED INCREASE IN D 18) PROPOSED SEWER ADT USAGE IN EDU □ 20) EXISTING GENERAL PLAN □ 23) PROPOSED ZONING D 21) PROPOSED GENERAL PLAN DESIGNATION D □ □ □ □ 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 P , 0~ FOR CITY USE ONLY FEE COMPUTATION APPLiCA TION TYPE TOT AL FEE REQUIRED DATE FEE PAID Form 16 FEE REQUIRED RECeva, NOV 2i 2001 CITY OF CARLSBAD DATE i-f-A\MNJNQ:_~ .. 1 ECEIVED RECEIVED BY: • RECEIPT NO. City of. Carlsbad . IREhi,hel~■•Ji·EIIU,14hi 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 fo11owing 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, fum, 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. I. 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 1HAN 10% OF 1HE 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.J:4'111:::S "1, Sf-11"1,a:@G1AAll2o Corp/Part. ___________ _ Title. ____________ _ Title ______________ _ Address (2 ( S: O YA-ft 2,c) c.J,l. D tZ.. 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 1HE SHARES, PLEASE INDICATE NON-APPLICABLE (NIA) 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 Philip G. Esbensen Corp/Part James M. Shimabukuro Title Owner Title Owner Address 6150 Yarrow Dr. -Address 4 0 5 Mimosa Ave. 1635 Faraday Avenue• Carlsbad, CA 92008-7314 • (760) 602-4600 • 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. ________ _ 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? D Yes 0 No If yes, please indicate person(s): _____________ _ NOTE: Attach additional sheets if necessary. Philip G. Esbensen James M. Shimabukuro 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 November 13, 2001 PHILIP ESBENSEN 6150 Yarrow Drive, Suite H Carlsbad, CA 92009 City of Carlsbad 1635 Faraday Ave. Carlsbad, CA 92008 Atten: Planning Dept. • In accordance with your letter of November 7, 2001, I hereby request EXTENSrON of CUP 250Bx1-PALOMAR DELt Attached is a check for $595.00. st:>ensen Pro rty Owner 6150 Yarrow Drive Carlsbad, Ca 92009 RECEIVED NOV 28 2001 CITY OF CARLSBAD PLANNING DEPT. --City of Carlsbad l:.JFihhlel·M•#l·Fiiiiel=ihl 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-partn~rship, joint venture, association, social club, fraternal organization, corporatieirt/ este,e, tn.,~t~ re~iver, syndicate, irr this and any ,other county, city and county, city muni:i:)tpality, distiict or ott!!er' political subd~visk>n ·or . any other group or combim1tion acting a!:!.!3· a· unit. H · Agents ,n,ay ·,~ign this doc1:1meht;, however, . theJeg!!i!, p~n:tt,Jmd entity ot ttle applicij~~ and, .property owner 11\USt 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 names, titles, and addresses of the corporate officers. (A separate page ma~ be attached if necessary.) Person °?AL.o fv\.~I(. 1) eL I Corp/Part ___________ _ Title_____________ Title ______________ _ ,_ \ $ V ,, ,-,,, u Address~ o LAtfloa,,.l u(., '-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 publicly-owned corporation, include the names, titles, and addresses of the corporate officers. (A separate page may be attached if necessary.) ' Person~E> M, S~tlC.tA8U,¼€b Corp/Part 4.,,.,A <;. ~tftMA13c.,Ct{(,l.tl> Title b~),.I~ Title e,w,.c!;-1L Address 40s-Mf t'\1.i>SA ~ Address tft>S-\',(, ~111-/:!-V5 1635 Faraday Avenue• Carlsbad, CA 92008-7314 • (760) 602-4600 • FAX (760) 602-8559 • www.ci.carlsbad.ca.us @ 3. NON-PROFIT ORGANIZATION OR TRUST 4. 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 ------------------------ 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? D Yes ~o If yes, please indicate person(s): ---------- NOTE: Attach additional sheets if necessary. I certify that all the above information is true and correct to the best of my knowledge. ,y1cjo1 ~Abb~ t>~ Signature of applicant/date it/ 11-J o / ~&:IM es tLf. ~4, 111 A e r,d\ (,( Co 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 RECEIVED JUN 2 3 1997 CITY OF CARLSBAD PWNING DEPT. GUARANTEE First American Title Insurance Company 124157 Form No. 1282 (Rev. 12/15/95) Form 1349 CLTA Guarantee Face Page (Revised 12/15/95) • First American Title Insurance Company SUBJECT TO THE EXCLUSIONS FROM COVERAGE, THE LIMITS OF LIABILITY AND THE CONDITIONS AND STIPULATIONS OF THIS GUARANTEE, First American Title Insurance Company a corporation, herein called the Company GUARANTEES the Assured named in Schedule A against actual monetary loss or damage not exceeding the liability amount stated in Schedule A, which the Assured shall sustain by reason of any incorrectness in the assurances set forth in Schedule A ,: , SCHEDULE A PROPERTY OWNER'S NOTICE GUARANTEE ORDER NO. 149704-M LIABILITY $200.00 FEE $125.00 1. NAME OF ASSURED: CITY OF CARLSBAD 2. DATE OF GUARANTEE: APRIL 30TH 1997 THE ASSURANCES REFERRED TO ON THE FACE PAGE HEREOF ARE: 1. THAT, ACCORDING TO THE LAST EQUALIZED ASSESSMENT ROLL ("ASSESSMENT ROLL 11 ) IN THE OFFICE OF SAN DIEGO COUNTY ASSESSOR'S OFFICE A. THE PERSONS LISTED BELOW AS 11 ASSESSED OWNER" ARE SHOWN ON THE ASSESSMENT ROLL AS OWNING REAL PROPERTY WITHIN 600 FEET OF THE LAND IDENTIFIED ON THE ASSESSMENT ROLL AS ASSESSOR'S PARCEL NUMBER { S) : 213-070-02 B. THE ASSESSOR' S PARCEL NUMBER {APN) AND ANY ADDRESSES SHOWN BELOW ARE AS SHOWN ON THE ASSESSMENT ROLL. 2. THAT, ACCORDING TO THE COMPANY'S PROPERTY RECORDS (BUT WITHOUT EXAMINATION OF THOSE COMPANY RECORDS MAINTAINED OR INDEXED BY NAME) , THERE HAVE BEEN NO DOCUMENTS RECORDED SUBSEQUENT TO APRIL 30TH 1997 PURPORTING TO TRANSFER TITLE TO ANY OF THE PROPERTIES LISTED BELOW, EXCEPT AS INDICATED.