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Home My WebLink AboutMCUP 07-13; Pickles Deli & Catering; Conditional Use Permit (CUP) (4)CITY OF .CARLSBAD LAND USE REVIEW APPLICATION 1) APPLICATIONS APPLIED FOR: (CHECKBOXES) (FOR DEPARTMENT USE ONLY) Administrative Permit Administrative Variance Coastal Development Permit Conditional Use Permit Condominium Permit Environmental Impact Assessment General Plan Amendment Hillside Development Permit Local Coastal Program Amendment Master Plan X| Minor Conditional Use Permit Non-Residential Planned Development Planned Development Permit Planned Industrial Permit Planning Commission Determination Precise Development Plan Redevelopment Permit Site Development Plan Special Use Permit Specific Plan Tentative Parcel Map Obtain from Engineering Department Tentative Tract Map Variance Zone Change List other applications not specified (FOR DEPARTMENT USE ONLY) 2) ASSESSOR PARCEL NO(S).: 3) PROJECT NAME: (W uA- 4) BRIEF DESCRIPTION OF PROJECT: ft 4<jW £C—i—i ^at^ bfJAt^-fr <^r*,e<4=w 5) OWNER NAME (Print or Type)6) APPLICANT r3AME (Print or Type) MAILING ADDRESS MAILING ADDRESS CITY AND STATE ZIP TELEPHONE CITY AND STATE ZIP TELEPHONE EMAILiDRESS:EMAIL ADDRESS: 1 CERTIFY THAT 1 AM THE LEGAL OWNER AND THAT ALL THE ABOVE INFORMATIONr ITRUE AND CORRECT TO THE BEST OF MY 1 CERTIFY THAT 1 AM THE LEGAL REPRESENTATIVE OF THE OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST Qf MY KNOWLEDGE SIGNATUE DATE BRIEF LEGAL DESCRIPTION A- f/\j .' 20^" &J-Q- 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 14 8) LOCATION OF PROJECT;67^ ^y. ON THE BETWEEN (NORTH, SOUTH, EAST, WEST) STREET ADDRESS SIDE OF AND (NAME OF STREET) (NAME OF STREET) 9) LOCAL FACILITIES MANAGEMENT ZONE 10) PROPOSED NUMBER OF LOTS 13) TYPE OF SUBDIVISION 16) PERCENTAGE OF PROPOSED PROJECT IN OPEN SPACE 19) GROSS SITE ACREAGE 22) 25) 11) NUMBER OF EXISTING RESIDENTIAL UNITS 14) PROPOSED IND OFFICE/ SQUARE FOOTAGE 17) PROPOSED INCREASE INADT 20) EXISTING GENERAL PLAN . 23) PROPOSED ZONING (NAME OF STREET) 12) PROPOSED NUMBER OF RESIDENTIAL UNITS 15) PROPOSED COMM SQUARE FOOTAGE 18) PROPOSED SEWER A* USAGE IN EDU 21) PROPOSED GENERAL PLAN DESIGNATION 24) HABITAT IMPACTS IF YES, ASSIGN HMP # IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE NECESSARY FOR MEMBERS OF CITY STAFF, PLANNING COMMISSIONERS, DESIGN REVIEW BOARD MEMBERS 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 s^ szffc. FOR CITY USE ONLY FEE COMPUTATION APPLICATION TYPE RECEIVED FEE REQUIRED SE? 13 2007 CITY OF CARLSBAD PLANNING DEPT DATE STAMP APPLICATION RECEIVED RECEIVED BY: TOTAL FEE REQUIRED Ruil, Form 14 City of Carlsbad Faraday Center Faraday Cashiering 001 0725601-1 09/13/2007 35 Thu Sep13,2007 04:14 PM PERMITS - PERMITS $680.00 Tran Nbr: 072560101 0004 0004 Trans/Rcpt#: R0066472 SET #: MCUP0713 FITEM(S): TOTAL: $680.00 Check (Chk# 003497} $680.00 Total Received: $680.00 Have a nice day! ***********:mCUSTQMER City of Carlsbad 1635 Faraday Avenue Carlsbad CA 92008 \ * i VcA-' Applicant: NASSER SOUMAYA TABARADD. Description MCUP0713 5650 EL CAMINO REAL CBAD Amount 680.00 Receipt Number: R0066472 Transaction Date: 09/13/2007 Transaction ID: R0066472 Pay Type Method Description Amount Payment Check 680.00 Transaction Amount: 680.00 City of Carlsbad ^P^p^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^H "5 UQpa 200? Planning Department 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. cannot be reviewed until this information is completed. Please print. Your project 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 ALL 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 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 £b(J W\^a ~7~(L\aa\- [Jed Cgforp/Part Title ^ g»'flf<&i *H • Title Q Address-ZnZl Address 0 (i\ 2. OWNER (Not the owner's agent) Provide the COMPLETE, LEGAL names and addresses of ALL 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 corporation or partnership, 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 Title L >Corp/Part Title 1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (760) 602-4600 • FAX (760) 602-8559 • www.ci.carlsbad.ca.us 3. NON-PROFIT ORGANIZATION OR TRUST If any person identified pursuant to (1) or (2) above is a nonprofit 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/TrustNon Profit/Trust_ 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? Yes 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 owner/date ••'Signature $f ap~plicant/date 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