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Home My WebLink AboutPUD 92-01F; LeClair House Addition; Planned Unit Development - Non-Residential (PUD) (4)CITY OF CARLSBAD ^ass^ LAND USE REVIEW APPLICATION ^1) APPLICATIONS APPLIED FOR: (CH [ 1 Administrative Permit Administrative Variance 1 1 Coastal Development Permit 1 1 Conditional Use Permit 1 1 Condominium Permit 1 1 Environmental Impact Assessment II General Plan Amendment 1 1 4Hillside Development Permit 1 1 Local Coastal Program Amendment D fiC Master Plan Non-Residential Planned Development Planned Development Permi C^lx ECK BOXES) (FOR DEPARTMENT USE ONLY) >«fz.-ol-p 1 J Planned Industrial Permit 1 1 Planning Commission Determination j j Precise Development Plan 1 1 Redevelopment Permit 1 1 Site Development Plan -D D D 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) 3) 4) ASSESSOR PARCEL NO(S).: PROJECT NAME: c? JV-53<J-o V~ . A H<U BRIEF DESCRIPTION OF PROJECT: 5) OWNER NAME (Print or Type) -Jv)saA> -f-"Joh^ * 6) APPLICANT NAME (Print or Type) /eCkir MAILING ADDRESS MAILING ADDRESS CITY AND STATE ZIP TELEPHONE CITY AND STATE ZIP TELEPHONE CA tC A few? EMAIL ADDRESS:EMAIL ADDRESS: I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE INFORMATtON IS TRUE ANB-CORRECT TO THE BEST OF MY KNOWLE I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND:T TO THEjaeft OF MY KNOWLEDGE. SIGNATURE DATE DATE BRIEF LEGAL DESCRIPTION NOTIE: A PROPOSED PROJECT REQUIRING MULTIPLE APPLICATIONS BE FILED, MUST BE SUBMITTED PRIOR TO 3:30 P.M. A PROPOSED PROJECT REQUIRING ONLY ONE APPLICATiON IBE FILED, MUST BE SUBMITTED PRIOR TO 4:00 P.M. n A r^r: -i r\r 8) LOCATION OF PROJECT:u^rfe*:/ rv-C4 (NORTH, SOUTH, EAST, WEST) ON THE BETWEEN | ; '3(N!AME OF STREET 9) LOCAL FACILITIES MANAGEMENT ZONE 10) PROPOSED NUMBER OF LOTS 13) TYPE OF SUBDIVISION STREET ADDRESS SIDE OF AND (NAME OF STREET) 11) NUMBER OF EXISTING RESIDENTIAL UNITS 16) PERCENTAGE OF PROPOSED PROJECT IN OPEN SPACE 19) £ GROSS SITE ACREAGE 22) EXISTING ZONING 25) 14) PROPOSED IND OFFICE/ SQUARE FOOTAGE 17) PROPOSED INCREASE INADT 20) EXISTING GENERAL PLAN 23) PROPOSED ZONING (NA1WE OrtSTREET) 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 PURB0SE SIGNATURE FOR CITY USE ONLY FEE COMPUTATION APPLICATION TYPE RECEIVED FEE REQUIRED CITY OF CARLSBAD PLANNING DEPT DATE STAMP APPLICATION RECEIVED RECEIVED BY: TOTAL FEE REQUIRED Form 14 Rev. 12/04 PAGE 2 OF 5 City of Carlsbad 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 Title ' n5 &Corp/Part Title Address 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 b"r 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 4-OfetT Corp/Part_ Title Address C<XA< sk/fr . I -f*Address. CA Avenue «, CA (7SO) fl02-46QQ • FAX (760) SOZ-6559 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 - '• Non 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? J Yes [cMo 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. r~ J*~J-^V~ f ^A ^\. / I Illf I W -^ 1 rtr^^^^— . Signature^ot owneT/daTe I ' Slgnafture'of applicant/dat 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 PROJECT DESCRIPTION/EXPLANATION PROJECT NAME: /pQl^/r o/TUg^ tf.M/~lG }J APPLICANT NAME: ±OS B >J -f- ^^ -/g f* fat /" 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: db t>*c,L V XoOOL ^ii -r Project Description 10/96 Page 1 of 1 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): C3 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. O 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: .S"ks/-r d -V ^oA/j /^pUi.r Name: A^eW/^IZM^ te.G-W.tr Address: 6^7"°^"V^ n ( v-i?.-5 Ui i ^i Address: Lf /^/ CXjA'^CJ^^'' ^-% rVlsW rA-?.ao69 C*J*LJi CA f^^ Phone Number: "~~7£ Address of Site: u> Local Agency (City and Assessor's book, page, Specify list(s): Regulatory Identificatior Date of List: ,0 ?3l /&O<7 Phone Number: 76 0 f3/-/^">f ^-e>^ U^Ai^a, / ^fih C&rUht.J CA &oo<j Countv): and parcel number: i Number: Propsrty^wner Signature/Date Admin/Counter/HazWaste 1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (760) 602-4600 • FAX (760) 602-8559 • www.ci.carlsbad.ca.us The Hazardous Waste and Substances Sites (Cortese List) is a planning document used by the State, local agencies and developers to comply with the California Environmental Quality Act requirements in providing information about the location of hazardous materials release sites. Government Code section 65962.5 requires the California Environmental Protection Agency to develop at least annually an updated Cortese List. Below is a list of agencies that maintain information regarding Hazardous Waste and Substances Sites. Department of Toxic Substances Control www.dtsc.ca.gov/database/calsites Calsites Hotline (916) 323-3400 State Water Resources Control Board www.swrcb.ca.gov/cwphome/lustis County of San Diego Certified Unified Program Agency (CUPA) Mike Dorsey Chief, Hazardous Materials Division Department of Environmental Health Services Hazardous Materials Management Division Mailing address: P.O. Box 129261 San Diego, CA 92112-9261 (619)338-2395 Call Duty Specialist for General Questions at (619) 338-2231 fax: (619) 338-2315 www.co.san-diego.ca.us Integrated Waste Management Board www.ciwmb.ca.gov 916-255-4021 Environmental Protection Agency National Priorities Sites ("Superfund" or "CERCLIS") www.epa.gov/superfund/sites/cursites (800)424-9346 National Priorities List Sites in the United States www.epa.gov/superfund/sites/npl/npl.htm 5/19/03 City of Carlsbad Faraday Center Faraday Cashiering 001 0611701-4 04/27/2006 32 Thu Apr27,2005 02:26 PM PERMITS - PERMITS $357.27 Tran Nbr: 061170104 0020 0024 Trans/Rept#: R0057000 SET #: CB061138 PERMITS - PERMITS $328.58 Tran Nbr; 061170104 0020 0025 Trans/Rcpttf: R0056998 SET #: PLID9201F 2 ITEMlS); TOTAL' $685.85 Check (Chk# 1017) $685.85 Totai Received: $685.85 Have a nice day! ***-m*****#**CUSTQMER COPY************* City of Carlsbad 1635 Faraday Avenue Carlsbad CA I 92008 Applicant: LECLAIR JOHN Description PUD9201F Amount 328.58 Receipt Number: R0056998 Transaction Date: 04/27/2006 Transaction ID: R0056998 Pay Type Method Description Amount Payment Check 328.58 Transaction Amount: 328.58 i j m-nw M fHtlt O J030,030003 Poinsettia Cove Maintenance Corporation -i * * i . ^^ M——*!», aj>^_c » ^^HBllENHHflH0i vVBDlPC^MPOn -^ -Ao W**_ - 10 I ny Midt tfe gyMm pf vi MMwgtmitfcrfee l««