HomeMy WebLinkAboutHDP 97-01; Cohen Residence; Hillside Development Permit (HDP)A
CITY OF CARLSBAD
LAND USE REVIEW APPLICATION
APPLICATIONS APPLIED FOR:
Master Plan
Specific Plan
Precise Development Plan
Tentative Tract Map
Planned Development Permit
Non-Residential Planned
Development
Condominium Permit
Special Use Permit
Redevelopment Permit
Obtain From Engineering Department
Administrative Variance
Administrative Permit - 2nd
(CHECK BOXES)
(FOR DEPARTMENT (FOR DEPARTMENT I
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
List other applications not
P
5) OWNER NAME (Print or Type) 16) APPLICANT NAME (Print or Type)
MAILING ADDRESS I MAILING ADDRESS
CITY AND STATE ZIP TELEPHONE
bq 1 cfi 4-q 931- 17a3
I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE
INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY
KNOWLEDG~
CITY AND STATE I $5) TELEPHONE
La s-, cct. 536 -btr 1
I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE
OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.
9JPd 9'2-
SIG URE DATE
7) BRIEF LEGAL DESCRIPTION d ~~VM ST IbW 3T"d~cf bd&i,
'?n+ibUL '43, MV,, lbbq , CTfY oe mL-2
~Ofei: A PROP~SED PROJECT REQUIRING MULTIPLE,APP~ICATIONS BE FILED, MUST BESUBMIT~ED*PRIOR TO 3:30 P.M.
A PROPOSED PROJECT REQUIRING'ONLY ONE APPLICATION BE;FILED, MUST BE SUBMITTED PRIOR TO 4:oo P.M.
Form 16 PAGE 1 OF 2
STREET ADDRESS
r
ON THE I hl0IG-m SIDE OF I Sw\rdlr GdWT
(NORTH, SOUTH, EAST, WEST) (NAME OF STREET)
BETWEEN AND &s\SU ITOS -tSbdC 1 (NAME OF STREET) I (NAME OF STREET)
9) LOCAL FACILITIES MANAGEMENT ZONE I 14 I
10) PROPOSED NUMBER OF LOTS IOI 11)
13) TYPE OF SUBDIVISION IR 114)
NUMBER OF EXISTING
RESIDENTIAL UNITS
PROPOSED IND OFFICE/
SQUARE FOOTAGE
16) PERCENTAGE OF PROPOSED
PROJECT IN OPEN SPACE
PROPOSED INCREASE IN
ADT
22) EXISTING ZONING
EXISTING GENERAL
PLAN
PROPOSED ZONING
PROPOSED NUMBER OF
RESIDENTIAL UNITS
PROPOSED COMM
SQUARE FOOTAGE
PROPOSED SEWER
USAGE IN EDU
PROPOSEDGENERAL
PLAN DESIGNATION
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
7
RECEIVED
FOR CITY USE ONLY
FEE COMPUTATION
APPLICATION TYPE FEE REQUIRED
kfb?
(0 @.eo b@or f7"
(zC?.ac,
JAN 0 7 1997
JAN 0 $997
v RECEIVED BY:
TOTAL FEE REQUIRED I ZZ0,OO 1
DATE FEE PAID
Form 16
I (-7-47
PAGE 2 OF 2
CITY OF CARLSBAD
1200 CARLSBAD . rLLAGE DRIVE CARLSBAD, C. JFORNIA 92008
434-2867 &+
REC'D FROM
ACCOUNT NO.
f "
RECEIPT MO. 36191
@ Printed on recycled paper.
DESCRIPTION 1 AMOUNT
NOT VALID UNLESS VALIDATED BY
CASH REGISTER
. k
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:
1. APPLICANT
List the names and addresses of all persons having a financial interest in the
application. am= R. NVdnEiL
4%W 2xlaPc.ir we
4- LA. -
2. OWNER
List the names and addresses of all persons having any ownership interest in the
property involved.
%s€Tzi tbugJ
C#". Ga-. Jbd &TaL\+ cmcr
3. If any person identified pursuant to (1) or (2) above is a corporation or partnership,
list the names and addresses of all individuals owning more than 10% of the shares
in the corporation or owning any partnership interest in the partnership.
NOdC
4. If any person identified pursuant to (1 1 or (2) above is a non-profit organization or a
trust, list the names and addresses of any person serving as officer or director of
the non-profit organization or as trustee or beneficiary of the trust.
).Ij14
2075 Las Palmas Dr. - Carlsbad. CA 92009-1 576 .- (61 9) 438-1161 - FAX (61 9) 438-0894 @
? 5. 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
(1 2) months?
0 Yes No If yes, please indicate person(s1:
Person is defined as ‘Any .individual, firm, co-partnership, joint venture, association, social club,
fraternal organization, corporation, estate, trust, receiver, syndicate, this and any other county, city
and county, city municipality, district or other ..political subdivision or q. any other group or
combination acting as a unit.’
NOTE: Attach additional sheets if necessary.
Y Signature of owner/date I
6 JLf 47
5CmtS-r toJlrJ, arp 7.. MJiZz.
Print or type name of owner Print or type name of applicant
Disclosure Statement 10/96 Page 2 of 2