HomeMy WebLinkAboutMCA 12-02; Title 20 Decision Making; _N/A~ «~~~:' ~ CITY OF
CARLSBAD
APPLICATIONS APPLIED FOR: (CHECK BOXES)
LAND USE REVIEW
APPLICATION
P-1
Development Services
Planning Division
1635 Faraday Avenue
(760) 602-4610
www.carlsbadca.gov
Development Permits (FOR DEPT. USE ONLY) Legislative Permits (FOR DEPT. USE ONLY)
0 Administrative Permit
0 Coastal Development Permit (*) 0 Minor
0 Conditional Use Permit (*)
0 Minor 0 Extension
0 Environmental Impact Assessment
0 Habitat Management Permit
0 Hillside Development Permit (*)
0 Plan.ned Development Permit
0 Minor
0 Residential 0 Non-Residential
0 Planned Industrial Permit
0 Planning Commission Determination
0 Site Development Plan
0 Special Use Permit
0 Tentative Tract Map/Parcel Map
0 Variance 0 Administrative
0 General Plan Amendment
0 Local Coastal Program Amendment(*)
0 Master Plan
0 Specific Plan
0 Zone Change (*)
0 Amendment
0 Amendment
~ ~Cf!e tmendment
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South Carlsbad Coastal Review Area Permits
0 Review Permit
0 Administrative 0 Minor 0 Major
Village Review Area Permits
0 Review Permit
0 Administrative 0 Minor 0 Major
(*) = eligible for 25% discount
./
NOTE: A PROPOSED PROJECT REQUIRING MULTIPLE APPLICATIONS MUST BE SUBMITTED PRIOR TO 3:30P.M. A PROPOSED PROJECT REQUIRING ONLY ONE
APPLICATION MUST BE SUBMITTED PRIOR TO 4:00P.M.
ASSESSOR PARCEL NO(S).: N { 1'\; C:...b.w\~
PROJECTNAME: -;-7{1....&. kC ~on.. .-.-L~
BRIEF DESC~IPTION OF PROJECT: K ad..c.:l2vt \A.....le..rA.....-c-~ u~~ ~ • z:s
C-f>i'l$~9. ~ \
LOCATION OF PROJECT:
ON THE:
BETWEEN
P-1
(NORTH,SOTH, EAST, WEST)
N,teJ:oF sTREET)
~FREET ADDRESS
SIDE OF 1\J LIt
(NAME OF STREET)
AND tJ/tr
(NAME OF STREET)
Page 1 of6 Revised 11/12
OWNER NAME (Print): APPLICANT NAME (Print): ~~ t>( ~ (.s,b.~
MAILING ADDRESS: MAILING ADDRESS: (CD..3S .f'l.v-~ .... ~ A;'# .e...-
CITY, STATE, ZIP: CITY, STATE, ZIP: C-,.. rl~..J.,....v.{ 1 C.f'\ ~~
TELEPHONE: TELEPHONE: 7CRO -V:>c::;z...-4~LO
EMAIL ADDRESS: EMAIL ADDRESS: flj. {-6.
I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE OWNER
INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO
KNOWLEDGE. THE BEST OF MY KNOWLEDGE.
SIGNATURE DATE SIGNATURE DATE
APPLICANT'S REPRESENTATIVE (Print):
MAILING ADDRESS:
CITY, STATE, ZIP:
TELEPHONE:
EMAIL ADDRESS:
I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE
APPLICANT AND THAT ALL THE ABOVE INFORMATION IS TRUE AND
CORRECT TO THE BEST OF MY KNOWLEDGE.
SIGNATURE DATE
IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE NECESSARY FOR MEMBERS OF CITY STAFF, PLANNING
COMMISSIONERS OR CITY COUNCIL MEMBERS TO INSPECT AND ENTER THE PROPERTY THAT IS THE SUBJECT OF THIS
APPLICATION. 1/WE CONSENT TO ENTRY FOR THIS PURPOSE.
NOTICE OF RESTRICTION: PROPERTY OWNER ACKNOWLEDGES AND CONSENTS TO A NOTICE OF RESTRICTION BEING
RECORDED ON THE TITLE TO HIS PROPERTY IF CONDITIONED FOR THE APPLICANT. NOTICE OF RESTRICTIONS RUN WITH
THE LAND AND BIND ANY SUCCESSORS IN INTEREST.
PROPERTY OWNER SIGNATURE
FOR CITY USE ONLY
P-1 Page 2 of6
£3{"1 {t2 .
'PL~~:J
DATE STAMP APPLICATION RECEIVED
RECEIVED BY:
I~
Revised 11/12