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INITIAL DOCUMENT(S) IMAGED BY IMAGED DATE
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PLANNING DEPARTMENT
ADDED DOCUMENT(S) IMAGED BY IMAGED DATE
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• CITY OF CARLSBAD
LAND USE REVIEW APPLICATION
1 ) APPLICA TIONS 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 91' oS 0 Special Use Permit
Assessment
0 General Plan Amendment 0 Specific Plan
0 Hillside Development Permit 0 =FeA~a~i"'e PaFeel Ma~
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
0 Planned Development Permit 0 List other applications not
specified
2)
3)
4)
ASSESSOR PARCEL NO(S).:
PROJECT NAME:
:(0'1-Oyo.~. ].oC(. CXoO·~ i 57 f; 59{ 114-(0 ~ 58
.::,ee. he..\ow I
BRIEF DESCRIPTION OF PROJECT:
5) OWNER NAME (Print or Type) 6) APPLICANT NAME (Print or Type)
w;\ l\~ ~. BU·rYtl\""'~
MAILING ADDRESS
CITY AND STATE ZIP TELEPHONE CITY AND STATE ZIP TELEPHONE
I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE
INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY
KNOWLEDGE.
SIGNATURE DATE
7) BRIEF LEGAL DESCRIPTION
(1r(sW
I CERTIFY THAT I AM THE LEGAL REPRESE A VE OF THE
OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND
CORRECT TO THE BEST OF MY KNOWLEDGE.
SIGNATURE DATE
NOTE: A PROPOSED PROJECT REQUIRING MULTIPLE 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, • rol""e.( IA.l. --\P tCR /~n C¥k.W ~,;
\ STREET ADDRES'r _
ON THE r! ----------.1 SIDE OF =1 ===l~===::::::::::======
(NORTH, SOUTH, EAST. WEST) (NAME OF STREET)
BETWEEN
(NAME OF STREET)
AND LI ______ ~~ __ -===----~
(NAME OF STREET)
9) LOCAL FACILITIES MANAGEMENT ZONE
I
15 ~ S
10) PROPOSED NUMBER OF LOTS D11) NUMBER OF EXISTING D12) PROPOSED NUMBER OF 0 RESIDENTIAL UNITS RESIDENTIAL UNITS 13} TYPE OF SUBDIVISION 014} PROPOSED IND OFFICEI 0 15) PROPOSED COMM 0 SQUARE FOOTAGE SQUARE FOOTAGE
16) PERCENTAGE OF PROPOSED 0 17) PROPOSED INCREASE IN 0 18) PROPOSED SEWER 0 PROJECT IN OPEN SPACE ADT USAGE IN EDU
19) GROSS SITE ACREAGE 0 20) EXISTING GENERAL D21) PROPOSED GENERAL 0 PLAN PLAN DESIGNATION 22) EXISTING ZONING 0 23) PROPOSED ZONING D
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
DATE $$s sU,.. APPLICATION RECEIVED
RECEIVED BY:
TOTAL FEE REQUIRED
DATE FEE PAID RECEIPT NO.
Form 16 PAGE 2 OF 2