HomeMy WebLinkAboutEIA 91-03; DOAN RESIDENCE; Environmental Impact Report (EIR)CITY OF CARL.SIBAD
LAND USE REVEEW APPLICATION FOR PAGE 10F2
1) APPLICATIONS APPLIED FOR: (CHECK BOXES)
(FOR DEPT
USE ONLY) (FOR DEPT
USE OL'()
0 Master Plan
O Specific Plan
Precise Development Plan
J Tentative Tract Map
Planned Development Permit
0 Non-Residential Planned Development
] Condominium Permit
Special Use Permit
Redevelopment Permit
Tentative Parcel Map
[ Administrative Variance
General Plan Amendment
Local Coastal Plan Amendment
Site Development Plan
Zone Change
Conditional Use Permit
Hillside Development Permit
Environmental Impact Assessment
Variance
Planned Industrial Permit
Coastal Development Permit
Planning Commission Determination
0 List any other applications not specificed
2) LOCATION OF PROJECT: ON THE I ,UL- SIDE OF
(NORTH, SOUTH SOUTH EAST, SD (NAMEd STREET)
BETWEEN elm 4 ( AND 5A Mq I
(NAME OF STREET) (NAME OF STREET) (1
3) BRIEF LEGAL DESCRIPTION:
4) ASSESSOR PARCEL NO(S).
5) LOCAL FACILITIES 6) EXISTING GENERAL PLAN j 7) PROPOSED GENERAL PLAN -
MANAGEMENT ZONE DESIGNATION DESIGNATION
8) EXISTING ZONING 9) PROPOSED ZONING - 10) GROSS SITE
ACREAGE
11) PROPOSED NUMBER OF j 112) PROPOSED NUMBER 13) TYPE OF SUBDIVISION
RESIDENTIAL UNITS I OF LOTS
(RESIDENTIAL
COMMERCIAL
14) NUMBER OF EXISTING RESIDENTIAL UNITS
INDUSTRIAL)
15) PROPOSED INDUSTRIAL - 116) PROPOSED COMMERCIAL - Ul OFFICE/SQUARE FOOTAGE SQUARE FOOTAGE
N0Th A 73P0SED paOJEcr REQUIRING ThAT MUL772 APIPUCATIONS BE PILED LT BE StMXTT) PRWR TO 33O PM. A PROPOSM PROJECT
REQUIRING THAT ONLY ONE AmcA*noN BE PILED i.EL BE SUBMI1TED MOR TO 400 PM. FRM00016 8/90
21)
F CAR-LS ---------4jj~- C I - fryZ-o -~-c -~-~B A D
LAND USE PAGE 2 OF 2
17) PERCENTAGE OF PROPOSED PROJECT IN OPEN SPACE
18) PROPOSED SEWER USAGE IN EQUIVALENT DWELLING UNITS I I I
19) PROPOSED INCREASE IN AVERAGE DAILY TRAFFIC / 0
20) PROJECT NAME: )/jf77 1/23/7e),(2I3
22) 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
PURPOSE
SIGNATURE
23) OWNER 24) APPLICANT
NAME (PRINT OR TYPE) NAME (PRINT OR TYPE)
MAILING ADDRESS MAILING ADDRESS
CITY AND STATE ZIP TELEPHONE CITY AND STATE ZIP TELEPHONE
I CERTIFY THAT I AM THE LEGAL OWNER I CERTIFY THAT I AM THE LEGAL OWNERs REPRESENTATiVE AND
AND THAT ALL THE ABOVE INFORMATION THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE
N TRUE AND CORRECT TO THE BEST OF BEST OF MY KNOWLEDGE.
MY KNOWLEDGE.
SIGNATURE DATE
SIGNATURE DATE
*******************************************************************************************************************
FOR CITY USE ONLY
FEE COMPUTATION:
APPLICATION TYPE FEE REQUIRED
DATE STAMP APPLICATION RECEIVED
-rrTr V rr n c\V 'Tn rr
RECEIVED BY:
( 2'1
-J
DATE FEE PAID RECEIPT NO. ____
SCAN
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