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Home My WebLink AboutPUD 88-04M; Reynolds Residence Remodel; Planned Unit Development - Non-Residential (PUD)e CITY OF CARLSBAD LAND USE REVIEW APPLICATION 1) APPLICATIONS APPLIED FOR: (CH [_J Administrative Permit |_~ I Administrative Variance (__] Coastal Development Permit 1 | Conditional Use Permit 1 j Condominium Permit LJ Environmental Impact Assessment L_j General Plan Amendment L~1 Hillside Development Permit Local Coastal Program Amendment Master Plan L 1 Non-Residential Planned Development J?^], Planned Development Permit ECK BOXES) (FOR /'(FOR DEPARTMENT DEPARTMENT USE ONLY) . .USE ONLY) R/nS3-» Planned Industrial Permit 1 1 Planning Commission Determination Precise Development Plan 1 1 Redevelopment Permit | 1 Site Development Plan LJ Special Use Permit j 1 Specific Plan 1 1 Tentative Parcel Map Obtain from Engineering Department Tentative Tract Map | 1 Variance | 1 Zone Change \J^\ List other applications not specified - 2) 3) 4) ASSESSOR PARCEL NO(S).: PROJECT NAME: ~ oo BRIEF DESCRIPTION OF PROJECT:/N/CIU&/A/6- 77) 5) OWNER NAME (Print or Type) [f. 6) APPLICANT NAME (Print or Type) MAILING ADDRESS MAILING ADDRESS CITY AND STATE ZIP TELEPHONE CITY AND STATE ZIP TELEPHONE -f-(LA EMAIL ADDRESS: ^f^CJiE/Vo £L#OT>v/WL,O~EMAIL ADDRESS:. 03*v\ 1 CERTIFY THAT 1 AM THE LEGAL OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDG / DATE / 1 CERTIFY THAT 1 AM THE LEGAL REPRESENTATIVE OF THE OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.'iDATE f 7) BRIEF LEGAL DESCRIPTION j_crr T/LAcr <Z(TT OP sf. NOTE: A PROPOSED PROJECT REQUIRING MULTIPLE Al? PLICATIONS BE FILED, MUST BE SUBMITTED PRIOR TO 3:30 P.M. A PROPOSED PROJECT REQUIRING OI>JLY ONE APPL|CAlrilQN BE FILED, MUST BE SUBMITTED PRIOR TO 4:00 P.M. ic 1 nc c 8) LOCATION OF PROJECT: STREET ADDRESS ON THE BETWEEN (NORTH, SOUTH, EAST, WEST) SIDE OF AND (NAME OF STREET) (NAME OF STREET) fiUSO 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) EXISTING ZONING 25) ENT ZONE I V/f\ r-^V &( ^ g^ 11) NUMBER OF EXISTING RESIDENTIAL UNITS 1 4) PROPOSED IND OFFICE/ SQUARE FOOTAGE 17) PROPOSED INCREASE INADT 20) EXISTING GENERAL PLAN 23) PROPOSED ZONING I MY ^V R^ t*T" (NAME OF STREET) 12) PROPOSED NUMBER OF RESIDENTIAL UNITS 15) PROPOSED COMM SQUARE FOOTAGE 18) PROPOSED SEWER 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 SIGrtATUR' FOR CITY USE ONLY FEE COMPUTATION APPLICATION TYPE FEE REQUIRED DATE S"? I \ OF ;EIVED_BY: TOTAL FEE REQUIRED Form 14 Rev. 12/04 PAGE 2 OF 5 PROJECT DESCRIPTION/EXPLANATION PROJECT NAME: APPLICANT NAME: QH*J -tf. Please describe fully the proposed project by application type. Include any details necessary to adequately explain the scope and/or operation of the proposed project. You may also include any background information and supporting statements regarding the reasons for, or appropriateness of, the application. Use an addendum sheet if necessary. Description/Explanation: bQ -„, Project Description 10/96 Page 1 of 1 City of Carlsbad••" •-—••-••• tf ,>jllp|l_Hlg_l_____l_.l.____^^^___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. 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 . 2. 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 JOHN U. Rey/va t-ajr Corp/Part Title Title Address 2->8g Address 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 /-/.Corp/Part_ Title A//. Address Address CA 1635 Faraday , CA 920Q&.7314 » (760) e02->160Q * FAX (760} 607-6S59 • www.ei.siMlsbiw3.ca.U5 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/Trust iJ /A Non Profit/Trust /V'/ A 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 \*\ No 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 ' Si^nalJofpplicant/date cj£ 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 H:ADMIN\COUNTER\DISCLOSURE STATEMENT 5/98 Page 2 of 2 * *City of Carlsbad Planning Department HAZARDOUS WASTE AND SUBSTANCES STATEMENT Consultation Of Lists of Sites Related To Hazardous Wastes (Certification of Compliance with Government Code Section 65962.5) Pursuant to State of California Government Code Section 65962.5, I have consulted the Hazardous Wastes and Substances Sites List compiled by the California Environmental Protection Agency and hereby certify that (check one): The development project and any alternatives proposed in this application are not contained on the lists compiled pursuant to Section 65962.5 of the State Government Code. The development project and any alternatives proposed in this application are contained on the lists compiled pursuant to Section 65962.5 of the State Government Code. APPLICANT PROPERTY OWNER Name: >#» M^ freVMo LteS Name: cW */ • tf. /lg Address: '3-g QaQyg vVt&TUgs Address: OS Phone Number: 9**?^V *-*?** 9- _ Phone Number: Address of Site: *2-i&£ do/^nr A(2jStn^s &A /L/cs,g/a£> C-A 71-0 Local Agency (City and County): vLAA^O>/>Js SA/vJ bl&&£> Assessor's book, page, and parcel number: Specify list(s): Regulatory Identification Number: Date of List: Ap^lica^Signature/Date Proper^ Otf^TSighature/Date Admin/Counter/HazWaste 1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (760) 602-4600 • FAX (760) 602-8559 • www.ci.carlsbad.ca.us