HomeMy WebLinkAboutHDP 00-03; SAHI - Reach 3; Hillside Development Permit (HDP)A
CITY OF CARLSBAD
LAND USE REVIEW APPLICATION
1) APPLICATIONS APPLIED FOR: (CHECK BOXES) I
Administrative Permit - 2nd
Dwelling Unit
Administrative Variance
Conditional Use Permit
Condominium Permit
Environmental Impact
Assessment
General Plan Amendment
Hillside Development Permit
Local Coastal Plan Amendment
Master Plan
Non-Residential Planned
Development
Planned Development Permit
I (FOR DEPARTMENT
00-Q3
Planned industrial Permit
Planning Commission
Determination
Precise Development Plan
Redevelopment Permit
Site Development Plan
Special Use Permit
Specific Plan
Obtain from Engineering Department
Tentative Tract Map
Variance
Zone Change
List other applications not
(FOR DEPARTMENT
USE ONLY)
I I
I I specified
2) ASSESSOR PARCEL NO(S).:
3) PROJECT NAME:
4) BRIEF DESCRIPTION OF PROJECT:
KNOWLEDGE. CORRECT TO THE BEST OF MY KNOWLEDGE.
SIGNATURE DATE
7) BRIEF LEGAL DESCRIPTION
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 SUBM~ED PRIOR TO 4:oo P.M.
Form 16
QW%OS%
PAGE 1 OF 2
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'- 8) LOCATION OF PROJECT:
I
ON THE 71 SIDE OF 1 I
(NORTH, SOUTH, EAST, WEST) (NAME OF STREET)
BETWEEN 7 AND 11
(NAME OF STREET) (NAME OF STREET)
LOCAL FACILITIES MANAGEMENT ZONE
PROPOSED NUMBER OF LOTS 1 1) NUMBER OF EXISTING
RESIDENTIAL UNITS
12) PROPOSED NUMBER OF
TYPE OF SUBDIVISION 14) PROPOSED IND OFFICE/ FI SQUARE FOOTAGE
15) PROPOSED COMM
PERCENTAGE OF PROPOSED 17) PROPOSED INCREASE IN TI 18) PROPOSED SEWER
PROJECT IN OPEN SPACE I I ADT 1 I USAGE IN EDU U
GROSS SITE ACREAGE 21) PROPOSED GENERAL
PLAN DESIGNATION
EXISTING ZONING 23) PROPOSED ZONING
IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE NECESSARY FOR MEPJlBERS 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 ENTRYFORTHISPURPOSE
SIGNATURE
FOR CITY USE ONLY
FEE COMPUTATION
APPLICATION TYPE FEE REQUIRED I I
TOTAL FEE REQUIRED 71
DATE FEE PAID
Form 16
I DATE STAMP APPLICATION RECEIVED
RECEIVED BY: '
RECEIPT NO. ' -1
PAGE 2 OF 2
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City of Carlsbad
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, fq 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.
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 comoration or Dartnershiu, include the
names, title, addresses of all individuals owning more than 10% of the shares. IF NO
APPLICABLE (N/A) IN THE SPACE BELOW If a publicly-owned comoration, include the
names, titles, and addresses of the corporate officers. (A separate page may be attached if
INDIVIDUALS OWN MORE THAN 10% OF THE SHARES, PLEASE INDICATE NON-
necessary.)
Person corp/Part
Title Title
Address Address
2. OWNER (Not the owner’s agent)
Provide the COMPLETE. LEGAL names and addresses of 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
comoration or UartnershiD, 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 publiclv-
owned corctoration, include the names, titles, and addresses of the corporate officers. (A separate
page may be attached if necessary.)
1635 Faraday Avenue 0 Carlsbad, CA 92008-7314 0 (760) 602-4600 FAX (760) 602-8559 @
fl
. 3. NON-PROFIT 0,. JANIZATION OR TRUST
If any person identified pursuant to (1) or (2) above is a nonmofit 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 Profiflrust Non Profiflrust
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?
c] Yes No 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.
Signature of ownerldate Signature of applicaddate
&G&rplp MurJwpw- b bla
Print or type name of owner Print or type name of applicant
rl 4
A Signature of hedapplicant’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