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Home My WebLink AboutHDP 98-14; Gilson Family Residence; Hillside Development Permit (HDP)CITY OF CARLSBAD LAND USE REVIEW APPLICATION 1) APPLICATIONS APPLIED FOR: (CHECK BOXES) I Administrative Permit - 2nd Dwelling Unit 0 Administrative Variance Coastal Development Permit 0 Conditional Use Permit 0 Condominium Permit 0 Environmental Impact 0 General Plan Amendment ca/ Hillside Development Permit 0 Local Coastal Plan Amendment 0 Master Plan 0 Non-Residential Planned 0 Planned Development Permit 2) ASSESSOR PARCEL NO(S).: - Assessment Development (FOR DEPARTMENT USE ONLY) (FOR DEPARTMENT USE ONLY) 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 specified .. 1 5) 0WNE.R NAME (Print or Type) 6) APPLICANT NAME (Print or Type) 4- /vl(rh GlL50hl KIRK 4 PITA GIWN MAILING ADDRESS MAILING ADDRESS 133% SCMOOdGle w4y l73d Sc!ffGQdW hh\1 CITY AND STATE ZIP TELEPHONE CITY AND STATE ZIP TELEPHONE fl D%i''4r SIGNATU E DATE SI NATU CORRE T TO T OF MY KNOWLEDGE. KNOWLE GE. OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND INFORMATION IS T AND CORRECT TO THE BEST OF MY I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE ddp- C& W.C)Og 760 -7dO*/ c/$~(-S@dQ, CAI liZm 7&9-7~20'544/ 7) BRIEF LEGAL DESCRIPTION PARCEL B of PARCEL MAP NO. 7%7q (CW of (?4rZLS040 ) NOTE: A PROPOSED PROJECT REQUIRING MULTIPLE APPLICATIONS BE FILED, MUST BE SUBMITTED PRIOR TO 3:30 P.M. A PROPOSED PROJECT REQUIRING ONLY ONE APPLICATION BE FILED, MUST BE SUBMITTED PRIOR TO 4:OO P.M. Form 16 PAGE 1 OF 2 LOCATION OF PROJECT: HOLLY BRAE STREET ADDRESS ON THE W=T 1 SIDE OF I HOW BPS6 (NORTH, SOUTH, EAST, WEST) (NAME OF STREET) BETWEEN AL0e.R AND !$\ILI NE, (NAME OF STREET) (NAME OF STREET) LOCAL FACILITIES MANAGEMENT ZONE I I PROPOSED NUMBER OF LOTS rl RESIDENTIAL UNITS bl SQUARE FOOTAGE 1 1) NUMBER OF EXISTING RESIDENTIAL UNITS 12) PROPOSED NUMBER OF TYPE OF SUBDIVISION 14) PROPOSED IND OFFICE/ SQUARE FOOTAGE 15) PROPOSED COMM r ".. .__.' PERCENTAGE OF PROPOSED PROJECT IN OPEN SPACE ADT 17) PROPOSED INCREASE IN 1101 USAGE IN EDU 18) PROPOSED SEWER GROSS SITE ACREAGE ml 20) EXISTING GENERAL PLAN DESIGNATION 21 ) PROPOSED GENERAL PLAN EXISTING ZONING PI 23) PROPOSED ZONING 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 FOR CITY USE ONLY FEE COMPUTATION TOTAL FEE REQUIRED I ' >IGP DATE FEE PAID Form 16 RECEIVED BY: ' @-&* 9-1-7- 98 1 RECEIPT NO. 153431 PAGE 2 OF 2 - - CITY OF CARLSBAD 1200 CARLSBAL ALLAGE DRIVE CARLSBAD, CALIFORNIA 92008 434-2867 ACCOUNT NO. DESCRIPTION RECEIPT NO. i-. :, , .;,,--, q 3 C'\ "r < NOT VALID UNLESS VALIDATED BY TOTAL I J'@ @ @ Printed on recycled paper. CASH REGISTER I ~- . ~ . ._ "" ~ _"".x ~ ."" - 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, firm, 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 persons having a financial interest in the application. If the applicant includes a corporation or partnership. 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 publiclv-owned corporation, include the names, titles. and addresses of the corporate officers. (A separate page may be attached if necessary.) INDIVIDUALS OWN MORE THAN 10% OF THE SHARES, PLEASE INDICATE NON- 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, noniprofit, corporation, etc.). If the ownership includes a corporation or PartnershiD, 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 publicly- owned corporation, include the names. titles. and addresses of the corporate officers. (A separate page may be attached if necessary.) Person I(\ W-I 6 / WO d Corp/Part Title OtdN6c Title Address Address 2075 Las Palmas Dr. - Carlsbad, CA 92009-1 576 0 (760) 438-11 61 FAX (760) 438-0894 @ i 3. NON-PROF11 JRGANIZATION 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 Profit/Trust Non ProfitlTrust 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? 0 Yes /IXINo 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. 4/17 hi? Krr~~c 6 (~~04 Llrzrc G5 ILSON Print or type name of owner Print or type name of applicant Signature of owner/applicant's agent if applicable/date Print or _.. type name,of owner/applicant's agent .,.,, . . I ..- J..ll " .' d:ADMIN\COUNTER\DISCLOSURE STATEMENT 5/98 Page 2 oi ::