HomeMy WebLinkAboutRP 07-04; Carlsbad Village Terrace; Redevelopment Permits (RP) (3)Citv of Carlsbad
Housing & Redevelopment 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, Cominission or Committee.
The following information MUST be disclosed at the time of application submittal. Your project cannot
be reviewed until this infomiation is completed. Please print.
Note:
Person is defined as "Any individual, firm, co-partnership, joint venture, association, social club, fratemai
orgamzation, 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 appUcant and property owner must be
provided below.
1. APPLICANT (Not the applicant's agenO
Provide the COMPLETE, LEGAL names and addresses of ALL persons having a fmancial
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 publiclv-owned corporation, include the
names, titles, and addresses of the corporate officers. (A separate page may be attached if
necessary.)
Corp/Part_
Title
Person
Title
• n
Address ^^0 • h:^ i^'oh Address
OWNER (Not the owner's agenO
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) Es[ THE SPACE BELOW. If a publiclv-
owned corporation, include the names, titles, and addresses of the corporate officers. (A separate
page may be attached if necessary.)
Person
Title t^JCmO^^^
Address
Corp/Part i^a^ ^^f^Vc
Title
Address ^^V^^
2965 Roosevelt St., Ste. B • Carlsbad, CA 92008-2389 • (760) 434-2810/2811 • FAX (760) 720-2037
NON-PROFIT ORGANIZATION OR TRUST
If any person identified pursuant to (1) or (2) above is a nonprofit organization or a tmst, list the
names and addresses of ANY person serving as an officer or director of the non-profit
organization or as tmstee or beneficiary of the.
Non Profit/Trust Non Profit/Trust
Title Title
Address Address
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?
I I Yes ^ s^o 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 Signature of applicant/date
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
ENVIRONMENTAL INFORMATION FORM
(To be Completed by Applicant)
Date Filed: 4AfJ ^^^7 (To be completed by City)
Application Number(s):
General Information
1. Name of project: _
2. Name of developer or project sponsor: )^g^3gr2-. P^S^J6LxDPAl5yJT
Address:
City, State, Zip Code: Cr:>9-^\^l^ P&^AAAc(2.^ ^Z^^Z^O
Phone Number: 'IK^ . ^d>o€>
3. Name of person to be contacted conceming this project: DAMiO LB3 SO^QAigS ^ A^^fTg^T
Address:
City, State, Zip Code: _
Phone Number: . AKo^ 6>
4. Address of Project: _
Assessor's Parcel Number:
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: _
7. Existing zoning district: g6?gVlQ^>1^g^^^
Existing land use(s):
9. Proposed use of site (Project for which this form is filed): ^^^W^J^kt. tV^Kckc.. CSf¥\d^
Project Description
10. Site size: 0.^2, kctS^"^
11. Proposed Building square footage:
12: Number of floors of constniction: 2^ ^5TS»(^^ (3A56^^^T"
13. Amount of ofT-street parking provided:
2
02/22/06
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 Negative
Declaration, Negative Declaration or Exemption) v^ll be required to be prepared for your
application, per the Califomia Environmental Quality Act (CEQA) and Title 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 (Le., 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 Negative Declaration is being sought. The more information provided in this form, the
easier and quicker it vsdll be for staff to complete the Environmental Impact Assessment Form -
Initial Study.
lc
14. Associated projects: toM^
15. If residential, include the number of units and schedule of unit sizes:
16. If commercial, indicate the type, whether neighborhood, city or regionally oriented, square footage of sales
area, and loading facilities:
17. If industrial, indicate type, estimated employment per shift, and loading facilities:
t4i=
18. If institutional, indicate the major fiinction, estimated employment per shift, estimated occupancy, loading
facilities, and community benefits to be derived fi-om the project:
19. If the project involves a variance, conditional use or rezoning applications, state this and indicate clearly
why the application is required:
Are the following items applicable to the project or its effects? Discuss all items checked yes (attach additional
sheets as necessary).
20. Change in existing features of any bays, tidelands, beaches, or hills, or
substantial alteration of ground contours.
Yes
•
No
K
21. Change in scenic views or vistas fi-om existing residential areas or public
lands or roads.
• X
22. Change in pattem, scale or character of general area of project. •
23. Significant amounts of solid waste or litter. •
24. Change in dust, ash, smoke, fiimes or odors in vicinity. •
25. Change in ocean, bay, lake, stream or ground water quality or quantity, or
alteration of existing drainage pattemsf ^
•
26. Substantial change in existing noise or vibration levels in the vicinity.
3
•
02/22/06
26
Yes JVo
Site on filled land or on slope of 10 percent or more. Q
28. Use of disposal of potentially hazardous materials, such as toxic Q
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, | |
etc.).
31. Relationship to a larger project or series of projects. Q
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. aJ>^ >k>t^^ fVlgpl^iJk. i3PR« , RJ^SlTS^ , C
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. I^^O^J/PffmrC PV^TIZ^^ , M *=^TI^<^?^>lZe^
Certification
I hereby certify that the statements fiimished 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 information presented
are true and correct to the best of my knowledge and belief
Date: Signature:
For: ^y>iLA (PeuNg^^pwe^i^
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):
• 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.
Name:
APPLICANT
Address:
Phone Number: . ^^'^^ ^OC>B
PROPERTY OWNER
Name! feTk^lStT. Offl^9U3PM6iUT
Address: Pg> fe»C <^(^
r^^C4ol^ OQU fMa CA ^2625
Phone Number 1\i^.ZZJ^,Acc^
Address of Site: O ^^e^^^ ^yiZggp
Local Agency (City and County): ^l^T^ gtF
Assessor's book, page, and parcel number:.
Specify list(s):
2^ ^ -{"b
Regulatory Identification Number:
Date of List:
Applicant Signature/Date^ f Property Owner Signature/D^e f *
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 LisL 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/lusfis
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
CARLSBAD FIRE DEPARTMENT
Fire Prevention Division
Land Use Review Report
PROJECT NAME: Carlsbad Village Terrace
Date: 02/07/07
Project number: RP 07-04 / CT 07-02
Staff Planner: C. Jones Engineer:
Proiect conditions: (Note: The following identifies specific conditions necessary to achieve
Fire Department approval.)
Fire sprinklers are required throughout this proiect including the sub-grade parking area.
Future submittals should indicate that Fire Sprinklers shall be provided.
It would be strongly suggested that the applicant/ developer reconsider individual v^^ater
supplies for the fire sprinkler system. The individual costs may prove to be impractical.
Each individual system would be required to provide an exterior alarm bell and
monitoring system if there are 100 or more sprinkler heads used. This would require 9
individual panel and monitoring contracts, and 9 alarm bells mounted on the exterior.
Lastly, if an system is designed and installed for the entire project there would be 1 meter
to be paid for not 9, there would be one backflow assembly v. 9, it is understood that a
larger appliance would be in order, however this would minimize utility impacts.
The only requirement would be that a maintenance agreement be memorialized.
GR