HomeMy WebLinkAboutRP 06-11; Carlsbad Christian Assembly; Redevelopment Permits (RP) (3)INSTRUCTION SHEET FOR FILLING OUT
ENVIRONMENTAL INFORMATION FORM
This Environmental Information Form will be used to assist staff in determining what type of
environmental documentation (i.e., Environmental Impact Report, Mitigated Negafive
Declaration, Negative Declaration or Exemption) will be required to be prepared for your
applicafion, per the Califomia Environmental Quality Act (CEQA) and Tifie 19 of Carlsbad's
Municipal Code. The clarity and accuracy of the information you provide is critical for purposes
of quickly determining the specific environmental effects ofyour project.
Any environmental studies (i.e., biological, cultural resource, traffic, noise) that are
necessary to substantiate a "no impact" or "yes impact" determination should be submitted
as an attachment to this Environmental Information Form. This is especially important
when a Negafive Declarafion. is being sought. The more informafion provided in this form, the
easier and quicker it will be for staff to complete the Environmental Impact Assessment Form -
Inifial Study.
ENVIRONMENTAL INFORMATION FORM
(To be Completed by Applicant)
Date Filed: (To be completed by City)
Application Number(s): •
General Information
1. Name of project: Q. A/LCl&ft/O TAAIUgTt/^/O /^SS^n^feUy S-fe/LAd^ Pv3i U)'^
2. Name ofdeveloper or project sponsor: OcO>->^*gJU '(lA/Li^'^&9tO O \\/U:^ri^> /kSS-*^^
Address:
City, State, Zip Code: ^' f? / A^^ - ^7_^n6
Phone Number: "^CpO- ^"2-^^ ^ "3 W t /
3. Name of person to be contacted conceming this project: j^Jm/^ r ,
Address: t I l^i^^h ^^STI\ OA^.
City, State, Zip Code: Sfii^ /KI/^^Cp^^ "^lunlS
Phone Number: La O ^5 "S^ ~ CPlSh )
4. Address of Project: ^QlV /4A/2^Q^^6> ST" ^ C^l^^rgf^^D ^CA ^ ^ZodS
Assessor's Parcel Number: ^ O'^-'^S"^^" f ^ O ^
5. List and describe any other related permits and other public approvals required for this project, including
those required by city, regional, state and federal agencies:
6. Existing General Plan Land Use Designation: iJ.
7. Existing zoning district: \^rJ^<^ .
8. Existing land use(s): 0<-^0 S'TXPCl^(=> IZ^ <i t^Hy^
9. Proposed use of site (Project for which this form is filed): ^TD/L^V^fag^ BaUiO^t^^ ,
Project Description
10. Site size:
11. Proposed Building square footage: .loOO • ir' \
12: Number of floors of construction: |L
13. Amount of off-street parking provided: ^ | ^
02/22/06
14. Associated projects: k) I A
15. If residential, include the number of units and schedule of unit sizes: 4
16. If commercial, indicate the type, whether neighborhood, city or regionally oriented, square footage of sales
area, and loading facilities: iJjh
17. If industrial, indicate type, estimated employment per shift, and loading facilities:
18. If institutional, indicate the major function, estimated employment per shift, estimated occupancy, loading
facilities, and community benefits to be derived from the project: *^ /
19. If the project involves a variance, conditional use or rezoning applications, state this and indicate clearly
why the application is required: A"
Are the following items applicable to the project or its effects? Discuss all items checked yes (attach aciditionai
sheets as necessary).
Yes No.
20. Change in existing features of any bays, tidelands, beaches, or hills, or Q \^
substantial alteration of ground contours.
21. Change in scenic views or vistas from existing residential areas or public
lands or roads.
22. Change in pattem, scale or character of general area of project. Q
23. Significant amounts of solid waste or litter. Q [7f^
24. Change in dust, ash, smoke, fiimes or odors in vicinity. Q 0^
25. Change in ocean, bay, lake, stream or ground water quality or quantity, or Q
alteration of existing drainage pattems.
26. Substantial change in existing noise or vibration levels in the vicinity. Q
3
02/22/06
26.
Yes No,
Site on filled land or on slope of 10 percent or more. [7l
28. Use of disposal of potentially hazardous materials, such as toxic Q (TK
substances, flammables or explosives.
29. Substantial change in demand for municipal services (police, fire, water, Q
sewage, etc.).
30. Substantially increase fossil fiiel consumption (electricity, oil, natural gas, Q
etc.).
31. Relationship to a larger project or series of projects.
Environmental Setting
Attach sheets that include a response to the following questions:
32. Describe the project site as it exists before the project, including information on topography, soil stability,
plants and animals, and any cultural, historical or scenic aspects. Describe any existing structures on the
site, and the use of the structures. Attach photographs of the site. Snapshots or Polaroid photos will be
accepted.
33. Describe the surrounding properties, including information on plants and animals and any cultural,
historical or scenic aspects. Indicate the type of land use (residential, commercial, etc.), intensity of land
use (one-family, apartment houses, shops, department stores, etc.), and scale of development (height,
frontage, set-back, rear yard, etc.). Attach photographs of the vicinity. Snapshots or polaroid photos will
be accepted.
Certification
I hereby certify that the statements fumished above and in the attached exhibits present the data and information
required for this initial evaluation to the best of my ability, and that the facts, statements, and infonnation presented
are true and correct to the best of my knowledge and belief
Date; ob Signature:
For: C^JLu^&AO UhiAlSTt^^ /^%SSM6^^
02/22/06
Citv 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):
1?^ 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: CAi2j,<.<^flO dU(2,\cT>AKl tetH6^ Name: ^jlX
Address: 8 Z.^ Cf^fLL^^hO UIWAUSL^ . Address:
Phone Number: ("H C> n'2..R-S^l/ Phone Number:
Address of Site: 3>OSr {-^OtlLOi.^^ ST. ^ CA/ZuLAfiAO, . ^ZJOG'P^
Local Agency (City and Countv): ^*T*] g>^ dpiLX^^t^^ S^^ T)tgu(»o ClooJ^
Assessor's book, page, and parcel number:
Specify list(s):
Regulatory Identification Number: .
Date of List:
Applicant Signjature/Dat
Admin/Counter/HazWaste
Property Owner Signature/Date
1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (760) 602-4600 • FAX (760) 602-8559 • www.ci.carlsbad.ca.us ^
NOTICE OF EXEMPTION
To: SD County Clerk
Attn: Anthony J. Consul
Mail Stop A-33
1600 Pacific Highway
San Diego CA 92101
From: CITY OF CARLSBAD
Planning Department
1635 Faraday Avenue
Carlsbad CA 92008
Subject: Filing of this Notice of Exemption is in compliance with Section 21152b of the Public
Resources Code (California Environmental Quality Act).
Project Title; Carlsbad Christian Assembly (RP 06-11)
Project Location - Specific: 3035 Harding Street
Project Location - City: Carlsbad Project Location - Countv: San Diego
Description of Project: Construct a 600 square foot storage building.
Name of Public Agency Approving Project: Citv of Carlsbad
Name of Person or Agency Carrying Out Project: Austin Silva
Name of Applicant: Don Metcalf (Carlsbad Christian Assemblv)
Applicant's Address: 825 Carlsbad Village Drive. Carlsbad, CA 92008
Applicant's Telephone Number: (760) 729-3411 Gregory J. Smith, Recorrfer/Cpunty Clei1(
Exempt Status: (Check One)
• Ministerial (Secfion 21080(b)(1); 15268);
• Declared Emergency (Section 21080(b)(3); 15269(a));
• Emergency Project (Section 21080(b)(4); 15269 (b)(c));
IXI Categorical Exemption - State type and section number: 15303 Class 3 (e)
I I Statutory Exemptions - State code number:
DEC 0 4 2Q06
A. Consul
BVL DEPUTY
Reasons why project is exempt: Accessory (appurtenant) structures will not have an adverse
significant impact on the environment.
Lead Agency Contact Person; Austin Silva Telephone; (^760)434-2812
//•28-OG
DON NEU, Acting Planning Director Date
Date received for filing at OPR:
FILED IN THt OFPiGt OF THE COUNTY CLERK
San Diego County on OEl Q 4 n^'' ^
Posted DFf 0 4 m Remov^ ^lAN O4?007
Returned to agency on. ' ^' 4 ^00/
Deputy. A. ConsuL Revised November 2005