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Home My WebLink AboutMCUP 08-04; ALGA CAMINO VERIZON - 1ST EXTENSION; Minor Conditional Use Permit (MCUP){_ City of Carlsbad LAND USE REVIEW APPLICATION P-1 Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.gov APPLICATIONS APPLIED FOR: (CHECK BOXES) Devalopmenf P,cm/ts D Coastal Development Permit D Minor Ix] Conditional Use Permit lj:~~ D Minor IZ] Extension ~-- 0 Day Care (Large) D Environmental Impact Assessment D Habitat Management Permit D HIiiside Development Permit 0Minor 0Minor D Nonconforming Construction Permit D Planned Development Permit D Minor D Residential D Non-Residential D Planning Commission Determination D Reasonable Accommodation D Site Development Plan D Special Use Permit 0Minor D Tentative Parcel Map (Minor Subdivision) D Tentative Tract Map (Major Subdivision) D Variance D Minor (FOR DEPT. USE ONLY) Leg/s/affve Penn/ts t,,\C,vPo~ -ot D General Plan Amendment D Local Coastal Program Amendment D Master Plan D Specific Plan D Zone Change •Amendment •Amendment D zone Code Amendment South Cfclsbad Coastal Rty1ew Am Permits D Review Permit D Administrative D Minor D Major VIiiage Review A,u Perm/ts D Review Permit D Administrative D Minor D Major (FOR DEPT. USE ONLY) NOTE: A PROPOSED PROJECT REQUIRING APPLICATION SUBMITTAL MUST BE BUBMITIED BY APPOINTMENT". PLEASE CONTACT THE APPOINTMENT SPECIALIST AT (710) 602-2723 TO SCHEDULE AN APPOINTMENT. •SAME DAY APPOINTMENTS ARE NOT AVAILABLE ASSESSOR PARCEL NO(S): 215-052-75-00 ----------------------------- LO CAT 1O N OF PROJECT: i>"I&• El Camino Real, Carlsbad, CA 92009 (STREET ADDRESS) NAME OF PROJECT: Alga Camino BRIEF DESCRIPTION OF PROJECT: CUP Renewal/Extension for MCUP 08-04 -"11~ eJ(k"tt,t.C,iM, 0\/1; \ PROJECT VALUE (SITE IMPROVEMENTS) N/A ESTIMATED COMPLETION DATE 4/14/18 FOR CITY USE ONLY Development No. :QW t)bQ ~ 1 Lead Casa No. P-1 Page 1 of6 Revised 03/17 • OWNER NAME (PLEASE PRINT) APPLICANT NAIIE (PU ,ASE PRINT) -INOMOUAL NAME INOMOUAL NAME /.. Uf}JIJ {l{)A;;,..____-(I applcable): (W applcalllo): COMPANY NAME l~~.,e,'=~~ ~ COMPANY NAME Verizon Wireless (If IPIIICllll8): (11 ..,.,.,_t MAILING ADDRESS: MAILING ADDRESS: 15505 Sand canyon Avenue CITY, STATE, ZIP: : ... ,., =.-~ ci 1 'c.A Sz.1a1 CITY, STATE, ZIP: lrvlne, CA 92618 TELEPHONE: ~~~f~~~~31 al~l£- TELEPHONE; 949-286-7000 EMAIL ADDRESS: EMAIL ADDRESS: NIA ,.,,... I CERTIFY THAT I All TiiE LEG.t.L OWNER AND THAT ALL THE ABOVE I CERTlfY THAT I /W THE LEG.t.L REPRESENTATIVE OF THE OWNER INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY AND THAT All THE ABOVE INFORMATION 18 TRUE AND CORRECT TO KNOWI.EDGE. I CERTFY AS LEGAL OWNER THIil THE APPLICANT AS THE BEST OF MY KNOWLEDGE, SET F, ~-IN 18 MY AUTilORIZED REPRESENTATIVE FOR PURPO ~71~ APPLICATION. ~C41Y/ -·?it1/J-2 /J /1.J "1 •) · {8- SIGNA)'JRE . DATE URE Dli E APPLICANT'S REPRESENTATIVE (Print): Jo Ann Stoddard MAILING ADDRESS: 2851 Csmlno Del Rio South, Suite 200 CITY, STATE,ZP: San Diego, CA 92108 TELEPHONE: 619-857-7277 EMAIL ADDRESS: JoAnn.Sloddard@TAEC.ne1. I CERTIFY THAT I /W THE REPRESENTATIVE OF THE APPLICANT FOR PURPOSES -~ ~?TION AND THIil ALL THE ABOVE INFOR-----18 CORRECT TO THE BEST OF MY --.. ;xz . ( ~ 1/12/18 SIGNAi~ l ) 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. I/WE CONSENT TO ENTRY FOR Tl-116 PURPOSE. NOTICE OF RESTRICTION: PROPERTY OWNER ACKNOWLEDGES ANO CONSENTS TO A NOTICE OF RESTRICTION BEING RECORDED ONLDIIH~TI,l!"ID HIS PROPERTY IF CONDITIONED FOR THE APPLICANT. NOTICE OF RESTRICTIONS RUN WITH THE LAND BIND CESSOR$ IN INTEREST. ~--~£:..,_~~.,, -J-RSIGNATU E P-1 Page 2 016 APR O 9 2018 CITY O,' CAr{LS'i'J\D DATElllU(Mf>'.'Af$JlblcM')~Rf!ffi:1VED Revised 03117 1/29/18 RE: Verizon Wireless Cell Site -Alga Camino Permit Extension Address: 1,151, El Camino Real, Carlsbad, CA Permit: MCUP 08-04 -Expiring April 14, 2018 Ms. Ruiz, REC" r:: I\,., .. D'' __ ,,, ' -\i .......... : APR O 9 2018 CITY Oi-L:1-,i·~LS. .D P.'...P.!\!!\!JN8 '.)J'/ :S: '.JN I am writing to request an extension on this Minor Conditional Use Permit (MCUP 08-04) on behalf of Verizon Wireless. Please see the provided forms and applications for this extension which include: -This written request -Disclosure Statement -Land Use Review Application -Development Permits form (appears the only additional item required is stated within Wireless Communication Facilities as it states a new RF study is required) -RF report -as per the above -Fees -1 set of plans If you should need anything else, please let me know! 2851 Camino Del Rio South Suite 200 San Diego, CA 92108 Tel (619) 857-7277 -- C.cityof Carlsbad DISCLOSURE STATEMENT P-1(A) Development Services Planning Division 1635 Faraday Awnue (760) 602-4610 www.carlsbadca.gov Applicant's statement or disclosure of certain ownership Interests on all sppllcstions \\tllch will require discretionary action on the part of the City Council or any appointed Board, Commission or Committee. The following Information MUST be disclosed st the time of application submittal. Your project cannot be reviewed until this Information Is completed. Please print. Note: P81'8on Is defined as "Any Individual, flnn, a:,-partnershlp, Joint venture, aseoc:latlon, social club, fraternal organization, a:,rporsllon, estate, trus~ receiver, syndicate, in this and any othar a:,unty, city and county, city munlclpallty, district or other pofftlcal subdivision or any oCher group or 1X1mlmation acting as a unit.• Agenta may sign lhls document: however, Iha legal name and entity of Ille applicant and property owner must be provided below. 1. 2. P-t(A) 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 corporaHon or partnership. Include the names, Utles, addresses of all lndlvldusls 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:QWDad corporaUon. Include the names, titles. and addresses of the corporate offlcers. (A separate age ma be ati!!ched if necessary.) Corp/Part Vt:f I 1-P VL- Tille Address tt :ne c , . I OWNER (Not Iha owner's agent) 'ff Title. __________ _ 4i,Q Address. __________ _ 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 corporatjon or partnershjp, include the names, tlUes, addresses of aO Individuals owning more than 10% of the shares. IF NO INDIVIDUALS OWN MORE THAN 10% OF THE SHARES, PLEASE INDICATE NON-APPLICABLE (NIA) IN THE SPACE BELOW. If a publicly-owned corporaHon, include the names, titles, and addresses of the corporate officers. (A separate page may be attached If necessary.) Person .. C -..1 /., S C b,v,. tr,., Corp/Part~---------- Tltle fr ,,.J,0 J Title. ___________ _ Address I 4Zo r~" &.c.. 5),.1?0 Address, ________ _ '> ... .., 0,..,} ri, CA 9.1.w1 Pago 1 of 2 Rev1Hd07NO 3. NON-PROFIT ORGANIZATION OR TRUST If any person identified pursuant to (1) or (2) above Is a nonprofit omanjzation or a trust. 11st the names and addresses of MY person serving as an officer or director of the non- profit organization or as trustee or beneficiary of the. Non Profit/Trust. ______ _ Non Profit/Trust. ________ _ Tme __________ _ Title ___________ _ Address~--------Address __________ _ 4. Have you had more than $500 worth of business transacted with any member of City staff, Boards, Commissions, Committees and/or Council within the past twelve (12) months? .-./' D Yes ~ No If yes, please Indicate person(s}: _________ _ NOTE: Attach additional sheets If necesssry. Jo Ann Stoddard above Information is true and correct to the best of my knowledge. ~~-, ·b 3/2-<1J 1; i Signature of applicant/date / / j :EbrA &i;hl/o RY-Veri2dYL- Pri~~t~~oe.~ tfr nt's agent If applicable/date Print or type name of owner/applicant's agent p.1(1,) Page 2 ol2 Re,nHd07/10