HomeMy WebLinkAboutEIA 00-01; DRAINAGE CHANNEL AND DESILTATION BASIN - CANNON ROAD; Environmental Impact Report (EIR)• • CITY OF CARLSBAD
LAND USE REVIEW APPLICATION
1 ) APPLICATIONS APPLIED FOR: (CHECK BOXES)
(FOR DEPARTMENT (FOR DEPARTMENT
USE ONLY) USE ONLY)
0 Administrative Permit -2nd 0 Planned Industrial Permit
Dwelling Unit
0 Administrative Variance 0 Planning Commission
Determination
0 Coastal Development Permit 0 Precise Development Plan
0 Conditional Use Permit 0 Redevelopment Permit
0 Condominium Permit 0 Site Development Plan
~ Environmental Impact E1 Pi00c10 ( 0 Special Use Permit
Assessment
0 General Plan Amendment 0 Specific Plan
0 Hillside Development Permit 0 +eFltati'Ie Pafeel Mal3
Obtain from Engineering Department
0 Local Coastal Plan Amendment 0 Tentative Tract Map
0 Master Plan 0 Variance
0 Non-Residential Planned 0 Zone Change
Development L -----l
0 Planned Development Permit 0 List other applications not I specified
5) OWNER NAME (Print or Type) C/O 6) APPLICANT NAME (Print or Type)
C I +If 0 C C4 rL b ~ J Dc-y: d i-ltUA~ ~~
MAILING" ADDRESS MAILING ADDRESS
Z01-l &s p~~ Dr-~ »'-<-
CITY AND STATE ZIP TELEPHONE CITY AND STATE ZIP TELEPHONE
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I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE
INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND ,KN°rlJ~ I /7/0 c)
CORRECT TO THE BEST OF MY KNOWLEDGE.
\ SIGNATURE
i
DATE SIGNATURE DATE
7) BRIEF LEGAL DESCRIPTION IJltl
NOTE: A PROPOSED PROJECT REQUIRING MULTIPLE APPLICATIONS BE ALED. MUST BE SUBMITTED PRIOR TO 3:30 P.M.
A PROPOSED PROJECT REQUIRING ONLY ONE APPLICATION BE ALED. MUST BE SUBMITTED PRIOR TO 4:00 P.M.
Form 16 PAGE 1 OF 2
I
IfiJOr~ ~ hd--~ J-+~ 1C.~ .. i?o~J 4CJ.L~J
~vJ \ L:s. CLL~ rvv~ iL--J.lJ uh' 8} LOCATION OF PROJECT:
STREET ADDRESS
ON THE SIDE OF
(NORTH. SOUTH, EAST, WEST) (NAME OF STREET)
BETWEEN
9) LOCAL FACILITIES MANAGEMENT ZONE
10) PROPOSED NUMBER OF LOTS D 11) NUMBER OF EXISTING
RESIDENTIAL UNITS
13) TYPE OF SUBDIVISION PROPOSED IND OFFICEI
SQUARE FOOTAGE
(NAME OF STREET)
PROPOSED NUMBER OF
RESIDENTIAL UNITS
PROPOSED COMM
SQUARE FOOTAGE
16) PERCENTAGE OF PROPOSED
PROJECT IN OPEN SPACE ~
0 14)
t:J171 NCREASE IN D 18) PROPOSED SEWER
USAGE IN EDU
19) GROSS SITE ACREAGE
22) EXISTING ZONING
EXISTING GENERAL
PLAN
/---D 23) PROPOSED ZONING
D 21) PROPOSED GENERAL
PLAN DESIGNATION
D
o o
o
D
24} IN THE PROCESS OF REVIEWING THIS APPLICATIO MAY BE NECESSARY FOR MEMBERS OF CITY
STAFF, PLANNING COMMISSIONERS, DESIGN EW BOARD MEMEBERS OR CITY COUNCIL MEMBERS
TO INSPECT AND ENTER THE PROPERTY T IS THE SUBJECT OF THIS APPLICATION. I/WE CONSENT
TO ENTRY FOR THIS PURPOSE
\j~
SIGNATURE ~
FOR CITY USE ONLY
FEE COMPUTATION
APPLICATION TYPE FEE REQUIRED
I
DATE STAMP APPLICATION RECEIVED
RECEIVED BY:
TOTAL FEE REQUIRED
DATE FEE PAID RECEIPT NO.
Form 16 PAGE 2 OF 2