HomeMy WebLinkAboutRP 05-10X1; State Street Mixed Use; Redevelopment Permits (RP)CITY OF CARLSBAD
LAND USE REVIEW APPLICATION
1) APPLICATIONS APPLIED FOR: (CHECK BOXES)
(FOR DEPT. USE ONLY) (FOR DEPT. USE ONLY)
• Administrative Permit • Planned Development Permit
• Administrative Variance • Planned Industrial Permit
• Coastal Development Permit • Planning Commission
Determination
• Conditional Use Permit • Precise Development Plan
• Condominium Permit • Redevelopment Permit
• Environmental Impact Assessment • Site Development Plan
• General Plan Amendment • Special Use Permit
• Habitat Management Plan Permit • Specific Plan
• Hillside Development Permit • Tentativo Parcel Map
Obtain from Engineering Department
• Local Coastal Program Amendment • Tentative Tract Map
• Master Plan • Variance
n Minor Conditional Use Permit • Zone Change
• Non-Residential Planned Development • List other applications not
specified
2) ASSESSOR PARCEL NO(S).: ^o'*^^ "
3) PROJECTNAME: ^TR fAfygiV 06p.
4) BRIEF DESCRIPTION OF PROJECT: - - ' ' -
5) OWNER NAME (Print or Type)
ohUil t^iM^ia-:> - i^A^ ^. LLC
6) APPLICANT NAME (Print or Type) |2^^^ j^ai^mt^
MAILING ADDRESS MAILING ADDRESS
^^^^^
' ) 7IP ' T\ CITY AND STATE ZIP TELEPHONE CITY AND STATB ' -'ZIP ' TELEPHONE
EMAILADDRESS: EMAIL ADDRESS:
I CERTIFY THAT I AM
INFORMATION IS
KNQWL
EGAL OWNER AND THAT ALL THE ABOVE
AND CORRECT TO THE BEST OF MY
7, 3'^^
I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE
OWNER AND THAT ALL^PrTE)AB0VE INFORMATION IS TRUE AND
CORRECT '^Sfm^SSFOVm KNOWLEDGE.
DATE SIGNATUR DATE
NOTE: A PROPOSED PROJECT REQUIRING MULTIPLE APPLICATIONS BE FILED, MUST BE SUBMITTED PRIOR TO 3:30 P.M.
A PROPOSED PROJECT REQUIRING ONLY ONE APPUCATION BE FILED, MUST BE SUBMITTED PRIOR TO 4:00 P.M.
Form 14 Rev. 03/08 PAGE 1 OF 4
7) BRIEF LEGAL DESCRIPTION 6 lA^^ "flUgf ^dJ^ ^ Ct^MtiRi , H/^
8) LOCATION OF PROJECT:
ON THE
BETWEEN
(NORTH, SOUTH, EAST, WEST)
SIDE OF
AND
*1 (NAMBC (NAMBOF STREET)
(NAME OF STREET) JAMf (NAMf OF STREET)
9) 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.
10) NOTICE OF RESTRICTION: PROPERTY OWNER ACKNOWLEDGES AND CONSENTS TO A NOTICE OF
RESTRICTION BEINQf RECORDED ON THE TITLE TO HIS PROPERTY IF CONDITIONED FOR THE
^S^^^NT/islOTICFOF RESTRICTIONS RUN WITH THE LAND AND BIND ANY SUCCESSORS IN INTEREST.
PROPERTY OWNER SIGNATURE
FOR CITY USE ONLY
DATE STAMP APPLICATION RECEIVED
RECEIVED BY:
Form 14 Rev. 03/08 PAGE 2 OF 4
City of Carlsbad
Housing & Redevelopment Department
DISCLOSURE STATEMENT
Applicant's statement or disclosiue of certain ownership interests on all applications which will require
discretionary action on the part of the Qty 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 con^>leted. Please print.
Note:
Person is defined as "Any imfividual, firm, co-partnaship, joint venture, assodatioii, social dub, finterpal
organization, corporation, estate, trust, receiver, syndicate, in ftis and any other county, dty and county, city
munidpality, distrid or other political sdxfivisionor any odwr group or comNnation 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 COMPLETR, l.^jRl^Al. names and addresses of ALL persons having a financial
interest in the application. If the applicant includes a cOTporation or partnership, include the
names, title, addresses of all individuals owning more thfm 10% of the shares. IF NO
INDIVIDUALS OWN MORE THAN 10% OF THE SHARES, PLEASE INDICATE NON-
APPUCABLE (N/A) IN THE SPACE BELOW If a publiclv-owned coiporation. include tiie
names, tities, and addresses of the ccxpocate officers. (A separate page may be attached if
necessaiy.)
Person
Title ^UUhAig^
Address. 7,8 0% t^i^<^
2. OWNER (Not the owner's agent)
Provide the COMPLETE. LEGAL names and addresses of ALL persons havmg any ownership
interest in the property involved. Also, provide the nature of the legal ownership (i.e,
partaership, tenants in common, non-fuofit, cQipofaticm, etc.). If the ownership includes a
coiporation or partnership, include the names, tide, addresses of all individuals owning more
tiian 10% of die shares. IF NO INDIVIDUALS OWN MORE THAN 10% OF THE SHARES,
PLEASE INDICATE NON-APPUCABLE (N/A) IN THB SPACE BELOW. If a PuMicly-
9wned corporation, include the names, tities, and addresses of the corporate officers. (A separate
^ -page may be attached if necessaiy.)
Person ()e»j|vJ ^fbMdM-S
Tide •
Corp/Part fL>^»^^(r^
Titie
Address
Coip/Part "^^^ ilA
Titie
Address Addxess
r^A o'>nn«)_9<9AO • rrwi ii.'%A-9fiin/9fi11 • PAX r7fiO> 720-2037 Sl^