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HomeMy WebLinkAboutRP 10-46; SEASIDE VILLAGE CORNER; Redevelopment Permits (RP) (2)CARLSBAD REDEVELOPMENT AGENCY PERMIT APPLICATION • PLEASE CHECK ALL THAT APPLY: ADMINISTRATIVE PERMIT New construction of building(s) Of addition's) to the building footprint which have a building permit valuation which is equal to or less than $60,000, Interior or exterior improvements to existing structures whicfi result in an intensity of use. Provisional land uses, where a minor or major redevelopment permit is not required. Changes in permitted land uses whidi result in siie changes, increased ADT, increased parking requirements, or result in com patibility issues/problems. Signs for existing businesses or faciiities. Repair or maintenance activflies which are not exempt from obtaining a permit. m COASTAL DEVELOPMENT PERMiT MAJOR REDEVELOPMENT PERMIT New construction of byildlng(s) or addition{s) to the building footprint which have a building permit valuation which is greater than S150,(X)0. Variances for projects within this category. MINOR REDEVELOPMENT PERMIT New construction of building(s) or addition(s) to the buiiding footprint which have a building permit valuation wtilcti is greater than $60,000 but less than $150,000. Variances for projects within this category. Variances for projects which would otherwise be exempt or be eligible for an administrative permit. • • MISCELLANEOUS REDEVELOPMENT PERMIT A-Frame Sign Sign Permit Sign Program Sidewalk Tables/Chairs Outdoor Displays Other PROJECT rmj=SeO C^LB^X^ ViUAgii^ C>f2-. /VvVxgD US^ ?>i2LC^ec^ Brief description of protect: ^o.^. ^ Property Location: street Address ggO gfvi2XjS>S«^ Vtcx^^gP*^ Owner's M^me^U^2&^ C^\Tfr^, Cc^ . Telephone Number <2?n a» '*5tt^ Applicant's Name daL^Z-Z^eTH ^eCJK^ Address 1^23 Pg/sjT|^ig t^/YSf^S. Tetephone Nomber Oil B^o-^WH ^ THEAREA: BELOWIS TO BECOMPLETED BY CITY STAFF^j^^^?-^^?^^->-^v^^?:^ "ITEES FOR APPLICATION PROCESSING: (List type of fee and amount) CDV 6/5 RECEIPT OF APPLICATION Date Application Received iLf 1110 Appiication Received by_ Permit Number Assigned. OtV 10 -IdD ^ CITY OF CARLSBAD LAND USE REVIEW APPLICATION P-1 Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.gov APPLICATIONS APPLIED FOR: (CHECK BOXES) Develooment Permits (FOR DEPT. USE ONLY) l^egl^l^tfve P^iml^ (FOR DEPT. USE ONLY) n Administrative Pennit n General Plan Amendment (2 Coastal Deveiopment Permit (*) L] Minor r~| Local Coastal Program Amendment (*) • Conditionai Use Permit (*) r~l Minor d] Extension n Master Plan C] Amendment n Environmentai impact Assessment r~l Speciflc Plan L] Amendment Q Habitat Inanagement Permit O Minor O Zone Change (*) 1 1 Hillside Development Permit (*) 1 1 Zone Code Amendment Planned Deveiopment Permit 1 1 Residential |3 Non-Residential Q Planned industrial Permit List other aoDlications not soecified n Planning Commission Determination • 1 1 Site Deveiopment Plan • Q Special Use Permit • n Tentative Tract Map {*) = eligible for 25% discount r~l Variance [~) Administrative NOTE: A PROPOSED PROJECT REQUIRINO MULTIPLE APPLICATIONS MUST BE SUBMITTED PRIOR TO 3:30 P.M. A PROPOSED PROJECT REQUIRING ONLY ONE APPUCATION MUST BE SUBMrTTED PRIOR TO 4:00 PJM. ASSESSOR PARCEL NO(S). PROJECT NAME: BRIEF DESCRIPTION OF PROJECT: 2 ^TOtZM &VICX^<NI<:>> BRIEF LEGAL DESCRIPTION: LOCATION OF PROJECT: S'^O Of^^l^Q/Yl^ \J\CU\^^ Dg. . ON THE: (NORTH, SOUTH, EAST, WEST) BETWEEN i'!'Prg,\>iN^ "ST (NAME OF STREET) SIDE OF AND STREET ADDRESS (NAME OF STREET) (NAME OF STREET) P-1 Page 1 of 5 Revised 07/10 OWNER NAME (Print): MAILING ADDRESS: pg^JTl^^,Dg (XOmfi.^ CITY, STATE, ZIP: ^t<x^f^i^ , C4\ ^ZOC^ TELEPHONE: <2>(7 S ilM EMAILADDRESS: eS?eCJ^& Githfiri U- APPLICANT NAME (Print): BueaS<C ^PtTifC MAILING ADDRESS: DgMTRO U^rr^iS> CITY, STATE, ZIP: ^gC3^ EMAILADDRESS: ^pe^l^ gi/K)^l C • C'orr\ I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. ciA^^^^^yPtV N JA^ 1^1 Z ho siGNATUp ' DATE APPLICANTS REPRESENTATIVE (Print): MAILING ADDRESS: CITY, STATE, ZIP: TELEPHONE: EMAILADDRESS: 1^ I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE APPLICANT AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. SIGNATURE DATE IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE NECESSARY FOR MEMBERS OF CITY STAFF, PLANNING COMMISSIONERS 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. NOTICE OF RESTRICTION: PROPERTY OWNER ACKNOWLEDGES AND CONSENTS TO A NOTICE OF RESTRICTION BEING RECORDED ON THE TiTLE TO HiS PROPERTY IF CONDITIONED FOR THE APPLICANT. NOTICE OF RESTRICTIONS RUN WITH THE LAND AND BIND ANY SUCCESSORS IN INTEREST. 2 PROPERTY OWNER SIGNATURE FOR CITY USE ONLY DATE STAMP APPLICATION RECEIVED RECEIVED BY P-1 Page 2 of 5 Revised 07/10 CARLSBAD PROJECT DESCRIPTION P-1{B) Deveiofffnent Services Pfanning Department 1635 Faraday Avenue (760) 602-4610 www, ca ris badca .gov PROJECTNAME' Carlsbad Village Drive Mixed-Use Project APPLICANT NAME: Bureck Capital, LLC / Elizabeth Speck 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: NEW MIXED-USE, OFFICE AND COMMERCIAL RETAIL, 2-STORY BUILDING, IN THE CARLSBAD VILLAGE REDEVELOPMENT ZONE, OFFICE SUPPORT AREA. SITE TO INCLUDE PARKING, LANDSCAPE IMPROVEMENTS, AS WELL AS BICYCLE RACKS, A PEDESTRIAN BENCH, AND 2 FUEL EFFICIENT VEHICLE PREFERRED PARKING SPACES. LEVEL 1 TO BE RETAIL WITH EITHER A COFFEE/TEA SHOP, SMALL NEIGHBORHOOD GROCERY/DELI, OR A CASUAL SIT-DOWN RESTAURANT. LEVEL 2 SHALL BE OFFICES. THIS PROJECT WILL BE LEED SILVER CERTIFIED. THE UNIQUE COMBINATION OF AVAILABLE PUBLIC TRANSPORTATION AND A BROWN FIELD SITE READY FOR DEVELOPMENT, ALLOWS THE 880 CARLSBAD VILLAGE DRIVE MIXED-USE PROJECT TO ACHIEVE 23 OUT OF 2 8 POSSIBLE LEED POINTS FOR SUSTAINABLE SITES. THE DEVELOPMENT IS LOCATED ON A PROPERTY THAT WAS PREVIOUSLY DEVELOPED AS A CONOCOPHILLIPS GASOLINE STATION. P-1{B) Pag© 1 of 1 Revised 04/09 Rjnn No, 1402.06 Po»cy Page 5 ALTA Ownert; Policy (6-17-06) Policy Number 406323 SCHEDULE A First American Title Irtsurance Company Name and Acidress of Title Insurance Connpany: Rrst American Title Insurance Company 4380 La Jolla Vfllage Drive; Suite 200 San Dlego, CA 92122 File NO.: NCS-406323-SD Policy No.: 406323 Address Reference: 880 Carlsbad Village Drive, Carlsbad, CA Amount Of Insurance: $1,250,000.00 Premfum: $2,408.00 Date of Policy: I^ecember 07, 2009 at 8:00 A.M. 1. Name of Bisured: Buredc Capital, LLC, a Califomia limited liability company 2. The estate or Interest In the Land tliat is Insured by this policy Is: Fee Simple 3. Title Is vested In: Buredc Capital, LLC, a Caiifomia limited liabiiity oompany 4. The Land referred to in this policy is desaibed as follows: Real property In the City of Carlsbad, County of San Diego, State of Carrfbmla, desaibed as foiiows: LOTS 29, 30, 31 AND 32, IN BLOCK 56 OF AMENI^D MAP OF THE TOWN OF CARLSBAD, COUNTY OF SAN DIEGO, STATE OF CAUFORNIA, AOOORPING TO MAP THEREOF NO. 775, FILED IN THE OFRCE OF THE COUNTY RECORDER OF SAFJ DIEGO COUNTY, FEBRUARY 15, 1894. EXCEPTING FROM FROM SAID LOT 32, THAT PORTION THEREOF CONVEYED TO THE OTY OF CARLSBAD BY DEEDS RKORDED OCTOBER 2,1990 AS FILE NOS. 90-538340 AND 90-538341 BOTH OF OFnOAL RECORDS OF SAID SAN DBEGO COUNTY. APN: 203-354-16-00 .A COASTAL DEVELOPMENT o,,,„„ Services PERMIT SUPPLEMENTAL PlanningDepartment ^ '=<^'' °l= APPLICATION 1635 Faraday Avenue CARLSBAD P-14 (760)602-4610 www.carlsbadca.gov This supplemental application is to be filed for any development requiring a Coastal Development Permit issued by the City of Carlsbad. **Application ctiecklist for Non-Single Family Regular Coastal Development Permits covered under separate tiandout. A proposed project requiring that multiple applications be filed must be submitted prior to 3:30 p.m. A proposed project requiring that only one application be filed must be submitted prior to 4:00 p.m. All joint application exhibits, i.e. Tentative Map and Planned Development Site Plan should be prepared at the same scale. (Use a scale no smaller than 1" = 40'.) I. GENERAL BACKGROUND A. Estimated Cost of Development: Development costing $60,000 or more does not qualify as a Minor Coastal Development Permit. The Planning Director shall make the final determination regarding a project's cost of development. The primary basis for determining cost of development will be the application of dollar costs per square foot for different types of residential construction. These costs are set by the International Conference of Building Officials (ICBO) and are applied throughout San Diego County. Please complete the following information to assist in the determination of this project's cost of development (Contractor proposals may also be submitted for consideration by the Planning Director). Please refer to the current fee schedule for the appropriate $/square foot fee rate. => New Residential Square Footage: i^|p» square feet x $ Isq. ft. = $ Residential Addition Square Footage^J square feet x $ Isq. ft. = $_ Any Garage Square Footage: lO |fv square feet x $ Isq. ft. = $_ Residential Conversion Square Footage: Pr square feet x $ Isq. ft. = $_ Please contact the City of Carlsbad Building Department for current fee rate for Non- Residential uses (i.e. Retail/Store; Restaurants; Office; and Manufacturing/Warehouse uses.) {OyOQ'h square feet x $ Isq. ft. = $ COST OF DEVELOPIVIENT ESTIMATE: $ P-14 Page lof 7 Revised 04/09 B. Do you wish to apply for: 1. A Minor Coastal Development Permit (Under $60,000 cost estimate) |^ 2. A Regular Coastal Development Permit ($60,000 or more cost estimate) f)^] C. Street address of proposed development D. Assessor's Parcel Number of proposed development Z4>S-35H-IC4 'C70 E. Development Description: Briefly describe proiect: 2^ ^CT^M e^Tfitiuf Of=-Pi^JE, SP^^ AVvxxQ^ F. Describe the present land uses (i.e. vacant land, single family homes, apartments, offices, etc.) that surround the proposed development to the: North: CF^IC^'S^ South: C4g\gX^eA-t^ ViU^KV€)e" I>g^ East: (S^Vi2^cSBiVtN> ^iLLAjSn^ C>g_. West: ig>Pi-KiV<^ G. Is project located within a 100-year flood plain? | [ves [^jCjsio PRESENT USE OF PROPERTY No A. Are there existing structures on the property? | [/es If yes, please describe. B. Will any existing structure be removed/demolished? | |Yes |^^io If yes to either question, describe the extent of the demolition or removal, including the relocation site, if applicable (also show on plans). III. LOT COVEIRAGE A. Existing and Proposed Existinq New Proposed Total Building Coverage 0 sq. ft. S.Z^ sq. ft. S{ZW sq. ft. Landscaped Area Q sq. ft. ^?f\ sq. ft. sq.ft. Hardscape Area Q sq.ft. 7^ (b3^ sq. ft. sq.ft. Unimproved Area (Left Natural) .fiA^sq. ft. 0 sq. ft. R ^^^sq. ft. P-14 Page 2 of 7 Revised 04/09 B. Paridng: Number of existing spaces 0 Number of new spaces proposed Existing/Proposed TOTAL: Number of total spaces required Number of covered spaces 0 Number of uncovered spaces Number of standard spaces \^ Number of compact spaces ^ Is tandem parking existing? QYes# Is tandem parking proposed? | IYOS #_ C. Grade Alteration: Is any grading proposed? | [ves ^No If yes, please complete the following: Amount of cut Amount of fill Maximum height of fill slope _ Maximum height of cut slope Amount of import or export _ Location of borrow or disposal site [SNO _cu. yds. .cu. yds. _feet _feet _cu. yds. The following materials shall be submitted for each application or for combined applications on a single project. P-14 Page 3 of 7 Revised 04/09 REQUIRED PLANS (All required plans shall be collated into complete sets, stapled together, then folded to 9" x 12" with lower riqht hand corner of plan visible.) A. SITE PLAN - Four (4) copies for a Minor Coastal Development Permit, four (4) copies for a Single Family Regular Coastal Development Permit on 24" x 36" sheet(s). Each site plan shall contain the following information: 1. GENERAL INFORMATION Qa. Name, address, and phone number of registered civil engineer, licensed surveyor, landscape architect or land planner who prepared the maps/plans. Ob. Location, size and use of all easements. •c. Dimensions and locations of: access, both pedestrian and vehicular, showing service areas and points on ingress and egress, off-street parking and loading areas showing location, number and typical dimension of spaces, and wheel stops. •d. Distance between buildings and/or structures. •e. Building setbacks (front, rear and sides). •f. Location, height and materials of walls and fences. Og. Dimensions/location of signs. Oh. A summary table of the following (if applicable to the application): 0(1) Street address and assessor's parcel number. 0(2) Site acreage. 0(3) Existing Zone and Land Use Designation. 0(4) Proposed land use. 0(5) Total building coverage. 0(6) Percent of site to be landscaped. 0(7) Number of parking spaces required/provided. 0(8) Square Footage of open or recreational space (if applicable). 0(9) Cubic footage of storage space (if applicable). Oi- All applicable Fire Suppression Zones as required by the City's Landscape Manual. B. GRADING AND DIAINAGE PLANS: Grading and drainage plans must be included with this application. In certain areas, an engineering geology report must also be included. Please consult the City Planning and Engineering Department representative for a determination on any grading plan geotechnical requirements if the project is in an overlay zone. The following information shall be submitted at a minimum: Ol- Approximate contours at 1' intervals for slopes less than 5%; 2' intervals for slopes between 5% and 10%; and 5' intervals for slopes over 10% (both existing and proposed). Existing and proposed topographic contours within a 100-foot perimeter of the boundaries of the site. Extend contours sufficiently out from the site to adequately show the adjacent floodplain (if applicable). 02. Earthwork volumes: cut, fill, import and export. 03. Spot elevations at the corners of each pad. 04. Method of draining each lot. Include a typical cross section taken parallel to the frontage for lots with less than standard frontage. 05. Location, width and/or size of all watercourses and drainage facilities within and adjacent to the proposed subdivision; show location and approximate size of any proposed detention/retention basins. 06. Clearly show and label the 100 year flood line for the before and after conditions for any project which is within or adjacent to a FEMA flood plain. P-14 Page 4 of 7 Revised 04/09 C. BUILDING ELEVATIONS AND FLOOR PLANS - Four (4) copies for a Minor Coastal Development Permit and four (4) copies a Single Family Regular Coastal Development Permit prepared on 24" x 36" sheet(s). Each building elevation and floor plan shall include the following information: 01. Location and size of storage areas. 02. All buildings, structures, wall and/or fences, signs and exterior lights. 03. Existing and proposed construction. 04. Provide documentation demonstrating compliance with City Council Policy 44 - Neighborhood Architectural Design Guidelines (if applicable). COLORED SITE PLAN AND ELEVATION PLAN - Not required with first submittal. It is the Applicant's responsibility to bring one (1) copy of a colored site plan and one (1) set of colored elevations to the Planning Department by 12:00 noon, eight (8) days prior to the Planning Commission meeting. Do not mount exhibits. IL REQUIRED DOCUMENTS AND SUBMITTAL ITEMS OA. A completed Land Use Review Application Form. OB. Completed Coastal Development Permit Application. Oc. Environmental Impact Assessment Part 1 with Regular Coastal Development Permits. Check with Planning staff regarding Minor Coastal Development Permits and Single Family Regular Coastal Development Permits for any environmental review requirements. OD- Disclosure Statement. BE. TWO (2) copies of the Preliminary Title Report (current within the last six (6) months). OF- Completed "Project Description/Explanation" sheet. OG. Two copies of a completed and signed "Storm Water Standards Questionnaire". This form can be found on the City's website: http://www.carlsbadca.qov/business/buildinq/Documents/E- 34.pdf (Distribute copy to Engineering). OH. If, when completing the Storm Water Standards Questionnaire, the project is defined as a "Priority Project", submit a preliminary Storm Water Management Plan (SWMP) prepared in accordance with the City Standard Urban Storm Water Mitigation Plan (SUSMP) per the City of Carlsbad Engineering Standards. Ol- Property Owner's List and Addressed Labels: NOTE: WHEN THE APPLICATION IS TENTATIVELY SCHEDULED TO BE HEARD BY THE DECISION MAKING BODY, THE PROJECT PLANNER WILL CONTACT THE APPLICANT AND ADVISE HIM TO SUBMIT THE RADIUS MAP. TWO SETS OF THE PROPERTY OWNERS LIST AND LABELS. THE APPLICANT SHALL BE REQUiRED TO SIGN A STATEMENT CERTIFYING THAT THE INFORMATION PROVIDED REPRESENTS THE LATEST EQUALIZED ASSESSMENT ROLLS FROM THE SAN DIEGO COUNTY ASSESSOR'S OFFICE. THE PROJECT WILL NOT GO FORWARD UNTIL THIS INFORMATION IS RECEIVED. 1. A typewritten list of the names and addresses of all property owners within a 600' radius of the subject property (including the applicant and/or owner). The list shall include the San Diego County Assessor's parcel number from the latest assessment rolls. 2. Two (2) separate sets of mailing labels of the property owners within a 600' radius of the subject property. The list must be typed in all CAPITAL LETTERS, left justified, void of punctuation. For any address other than single-family residence, an apartment, suite or building number must be included on a separate line. DO NOT include it on the street address line. DO NOT TYPE ASSESSOR'S PARCEL NUMBER ON LABELS. DO NOT provide addressed envelopes - PROVIDE LABELS ONLY. Acceptable fonts are: P-14 Page 5 of 7 Revised 04/09 Arial 10, Enterprise TM or Courier NEW (TT) no larger than 11 pt. Sample labels are as follows: UNACCEPTABLE UNACCEPTABLE ACCEPTABLE Mrs. Jane Smith Mrs. Jane Smith MRS. JANE SMITH 123 Magnolia Ave., Apt #3 123 Magnolia Ave. APT 3 Carlsbad, CA 92008 Apt. #3 123 MAGNOLIA AVE Carlsbad, CA 92008 CARLSBAD CA 92008 600' Radius Map: A map to scale not less than 1"=200' showing each lot within 600' of exterior boundaries of the subject property. Each of these lots shall be consecutively numbered and correspond with the property owners list. The scale of the map may be reduced to a scale acceptable to the Planning Director ifthe required scale is impractical. 100' Radius Occupants/Address List and Labels (for coastal zone/CDPs only): One (1) list of the occupants/addresses located within a 100' radius of the project site; and two (2) sets of labels (as described in "A" above) ofthe addresses within a 100' radius. SPECIFIC PROJECT REQUIREMENTS - (May apply to single family, regular and minor coastal development permits). Coastal Overlay Zones require additional information to be submitted as follows: (refer to the Municipal Code for a full description) A. Coastal Agriculture Overlay Zone 1. Refer to the Carlsbad Municipal Code Section 21.202.060 for specific requirements. B. Coastal Resource Protection Overlay Zone 1. Slope analysis/mapping for 25% and greater subject to Section 21.203.040 of the Carlsbad Municipal Code. 2. Topographic and vegetation mapping/analysis subject to Subsection 21.203.040(B)(1) of the Carlsbad Municipal Code, if project is located along the first row of lots bordering Buena Vista Lagoon including the lagoon mouth. 3. Topographic, drainage and wetland mapping subject to Subsections 21.203.040(B)(2)(a) and (b) of the Carlsbad Municipal Code if located east of Interstate 5 in the Batiquitos Lagoon watershed. 4. Drainage study subject to Subsection 21.203.040(B)(3) of the Carlsbad Municipal Code if project is located west of existing Paseo del Norte, west of Interstate 5 or along El Camino Real immediately upstream of existing storm drains. 5. Geologic report addressing landslides and slope stability subject to Subsection 21.203.040(B)(4) ofthe Carlsbad Municipal Code. 6. Geologic report addressing landslides and seismic hazards subject to Subsection 21.203.040(C) and (D) ofthe Carlsbad Municipal Code. C. Coastal Shoreline Development Overlay Zone 1. Geotechnical report subject to 21.204.110 if project is located adjacent to an existing seabluff edge between the sea and the first public road parallel to the sea; also may be required by Planning Director if deemed necessary consistent with Section 21.204.110 of the Carlsbad Municipal Code. 2. Show all structures and decks on adjacent north and south properties to perform "stringline" test subject to Subsection 21.204.050(B) ofthe Carlsbad Municipal Code. 3. Unless othen^/ise submitted, a project in this zone must also submit plans showing: a. Boundaries and topography b. Existing and proposed structures c. Circulation d. Drainage e. Finished topography f. Landscaping P-14 Page 6 of 7 Revised 04/09 D. Coastal Resource Overlay Zone Mello I LCP Segment 1. Erosion, sedimentation and drainage report subject to Section 21.205.060 of the Carlsbad Municipal Code if project is located in the Batiquitos Lagoon watershed. IV. REQUIRED COASTAL PERMIT FINDINGS - Approval of a regular or minor coastal development permit is based on the ability to make three coastal related findings. These three findings are presented below for your review and information. 1. That the proposed development is in conformance with the Certified Local Coastal Program and all applicable policies. 2. That the development is in conformity with the public access and public recreation policies of Chapter 3 of the Coastal Act. 3. That the development conforms with any applicable decision pertinent to this proposal and/or site as set by the Coastal Commission on a previously related appeals decision per Public Resources Code §30604(c). P-14 Page 7 of 7 Revised 04/09 ^ DISCLOSURE Dev-elopment Services STATEMENT Planning Department C ^ ^'^ OF n 4/A\ 1635 Faraday Avenue r API ^RAD ^ ^ (7601602-4G10 www.carlsbadca.gov 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 foilowing 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, fratemai organization, corporation, estate, trust receiver, syndicate, in this and any other cminty, dty and county, dty municipality, district or other political suMrvision 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 provide below. 1, 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, titles, 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 pubticlv-owned corporatjon. include the names, titles, and addresses of the corporate officers, (A separate page may be attached if necessary.) Person SeAisa tSPegru^ Corp/Part BUIZ^CIC ^>H=>iTi^ Title 4^g>e£>\J>e:N^ Title Address \^Z3 peNjTfgQ i>e 6o/y\fg> Address l^zs pgKinsic -De: ^Q^f^ B>^t<2>P(<3^, ^2003 e^r^S>tfL^ ^2^0-3 2. 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, trtles, 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.) Person^e/VNi -^pa^ Coro/Part fegvaec^ CAPa^<^ Title PtZj^'S\^&JV Title AddresspeKrrgx^ Pg OoMfyS> Address l^^Z& TJEK/TRO (j^ff\rG> p-1 {A} Page 1 of 2 Revised 04,-09 3. NON-PROFIT ORGANIZATION OR TRUST N] pr If any person identified pursuant to (1) or (2) above Is a nonprofit organization or a trust, (ist the names and addresses of AN Y person serving as an officer or director of the non- profit organization or as trustee or beneficiary of the. Non Profit/Trust Non Proftt/Trust Title ^ Title Address Address 4. Have you had more tian $500 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 alt the above information is true and correct to the best of my knowledge, : iz^/ S/lC Signature ofiepplicant/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 p-1 {A) Pag© 2 of 2 R®¥is«l 04/09 ^ HAZARPOUS WASTE Development Services ANP SUBSTANCES Planning Division CITY OF STATEMENT I635 Faraday Avenue CARLSBAD p.i(C) (760) 602-4610 www.carlsbadca.gov 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 Waste and Substances Sites List compiled by the California Environmental Protection Agency and hereby certify that (check one): Kj 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. n The development project and any alternatives proposed in this application §re contained on the lists compiled pursuantto Section 65962.5 ofthe State Government Code. APPUCANT PROPERTY OWNER Name:^J12eC^ /^PaA-t_ Name: M^-^CK^ (^V^lT^C Address: l^g^gg, pgNjngQ pe or^Anft^ Address: PeivrrR^o P^Og/)l^^ Phone Number: (b(7 -^5C/ StfM Phone Number: OH d^O S\l<-\ Address of Site: ^SO 6ft-g^ej%i> \ilU.J^^ 7X2^- Local Agency (City and Countv): (^/^i^QAD , "S^NA t>lgg)6 Assessor's kxDok, page, and parcel number: 'S>SM ~ I <g> Specify list(s): Regulatory Identification Number:, Date of List: )plic^Signature/Date ' ' Property Owrier Signature/Date * Appl The Hazardous Waste and Substances Sites List (Cortese List) is used by the State, local agencies and developers to compiy with the California Environmentai Quality Act requirements in providing information about the location of hazardous materiais release sites. P-1 (C) Page 1 of 2 Revised 07/10 ^ HAZARPOUS WASTE Develoomer,t Services CITY OF yy^ ANP SUBSTANCES Planning Division CARLSBAD^^v> STATEMENT ''''TeZ^Zl P-1(C) www.carlsbadca.gov Per the California Environmental Protection Agency's website, "While Govemment Code Section 65962.5 [referred to as the Cortese List] makes reference to the preparation of a list," many changes have occurred related to web-based information access since [the amended statute's effective date in] 1992 and this information is now largely available on the Internet sites of the responsible organizations. Those requesting a copy of the Cortese list" are now referred directly to the appropriate information resources contained on the Intemet web sites of the boards or departments that are referenced in the statute." Beiow is a list of agencies that maintain information regarding hazardous waste and substances sites. Department of Toxic Substances Control www.calepa.ca.qov/sitecleanup/CorteseList/default.htm www.calepa.ca.qov/database/calsites www.envirostor.dtsc.ca.qov/public EnviroStor Heip Desk (916) 323-3400 State Water Resources Control Board http://qeotracker.waterboards.ca.qov/ County Of San Diego Department of Environmental Heaith Services www.co.san-dieqo.ca.us/deh Hazardous Materiais Division www.sdcountv.ca.qov/deh/hazmat/hazmat permits.html Mailing Address: County of San Diego Department of Environmental Health P.O. Box 129261 San Diego, CA 92112-9261 Call Duty Specialist for technical questions at (619) 338-2231, fax (619) 338-2377 Environmental Protection Agency National Priorities Sites ("Superfund" or "CERCLIS") www.epa.qov/superfund/sites/cursites (800) 424-9346 or (702) 284-8214 National Priorities List Sites in the United States www.epa.qov/superfund/sites/npl/npl.htm p-1 (C) Page 2 of 2 Revised 07/10 STORM WATER Development Services Land Development Engineering STANPARPS Development Services Land Development Engineering ^ CITY OF QUESTIONNAIRE 1635 Faraday Avenue CARLSBAD E-34 760-602-2750 www.carlsbadca.gov INSTRUCTIONS: To address post-development pollutants that may be generated f|-om development projects, the City requires that new development and significant redevelopment priority projects incorporate Permanent Storm Water Best Management Practices (BMP's) into the project design perthe City's Standard Urban Stormwater Management Plan (SUSMP). Initially this questionnaire must be completed by the applicant in advance of submitting for a development application (subdivision, discretionary permits and/or construction permits). The results of the questionnaire determine the level of storm water standards that must be applied to a proposed development or redevelopment project. Depending on the outcome, your project will either be subject to 'Standard Stormwater Requirements' or be subject additional criteria called 'Priority Development Project Requirements'. Many aspects of project site design are dependent upon the storm water standards applied to a project. Applicant responses to the questionnaire represent an initial assessment of the proposed project conditions and impacts. City staff has responsibility for making the final assessment after submission of the development application. If staff determines that the questionnaire was incorrectly filled out and is subject to more stringent storm water standards than initially assessed by the applicant, this will result in the return of the development application as incomplete. In this case, please make the changes to the questionnaire and resubmit to the City. If applicants are unsure about the meaning of a question or need help in determining how to respond to one or more of the questions, they are advised to seek assistance from Land Development Engineering staff. A separate completed and signed questionnaire must be submitted for each new development application submission. Only one completed and signed questionnaire is required when multiple development applications for the same project are submitted concurrently. In addition to this questionnaire, applicants for construction permits must also complete, sign and submit a Project Threat Assessment Form to address construction aspects of the project. Please answer the questions below, follow the instructions and sign the form at the end. 1. Is your project a significant redevelopment? M.^S DEFINITION: Significant redevelopment is defined as the creation, addition or replacement of at least 5,000 square feet of impervious surface on an already existing developed site. Significant redevelopment includes, but is not limited to: the expansion of a building footprint; addition to or replacement of a structure; structural development including an increase in gross floor area and/or exterior construction remodeling; replacement of an impervious surface that is not part of a routine maintenance activity; and land disturbing activities related with structural or impervious surfaces. Replacement of impervious surfaces includes any activity that is not part of a routine maintenance activity where impen/ious material(s) are removed, exposing underlying soil during construction. If your project IS considered significant redevelopment, then please skip Section 1 and proceed with Section 2. If your project IS NOT considered significant redevelopment, then please proceed to Section 1. E-34 Page 1 of 3 REV 4/30/10 ^ CITY OF CARLSBAD STORM WATER STANPARPS QUESTIONNAIRE E-34 Development Services Land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov SECTION 1 NEW DEVELOPMENT ' PRIORITY PROJECT TYPE Does you project meet one or more of the foliowing criteria: YES NO 1. Housina subdivisions of 10 or more dwellina units. Examples: single family homes, multi-familv homes, condominium and apartments 2. Commercial - areater than 1-acre. Anv development other than heavy industry or residential, Examples: hospitals; laboratories and other medical facilities; educational institutions; recreational facilities; municipal facilities; commercial nurseries; multi-apartment buildings; car wash facilities; mini-malls and other business complexes; shopping malls; hotels; office buildings; public warehouses; automotive dealerships; airfields; and other light industrial facilities. 3. Heavv Industrial / Industrv- areater than 1 acre. Examoles: manufacturing plants, food processing plants, metal working facilities, printing plants, and fleet storage areas (bus, truck, etc.). 4. Automotive reoair shoo. A facility cateqorized in any one of Standard Industriai Classification (SIC) codes 5013, 5014, 5541, 7532-7534, and 7536-7539 5. Restaurants. Anv facilitv that sells prepared foods and drinks for consumption, including stationary lunch counters and refreshment stands selling prepared foods and drinks for immediate consumption (SIC code 5812), where the land area for development is greater than 5,000 square feet. Restaurants where land development is less than 5,000 square feet shail meet ail SUSMP requirements except for structural treatment BMP and numeric sizing criteria requirements and hydromodification requirements. 6. Hillside develooment Anv develooment that creates 5,000 square feet of impervious surface and is located in an area with known erosive soil conditions, where the development will grade on any natural slope that is twenty-five percent (25%) or greater. 7. Environmentallv Sensitive Area (ESA^. Atl develooment located within or directly adjacent^ to or discharging directly^ to an ESA (where discharges from the development or redevelopment will enter receiving waters within the ESA), which either creates 2,500 square feet of impervious surface on a proposed project site or increases the area of imperviousness of a proposed project site to 10% or more of its naturally occurring condition. 8. Paridna lot. Area of 5,000 square feet or more, or with 15 or more parking spaces, and potentially exposed to urban runoff 9. Streete. roacte. hiahwavs. and freewavs. Anv paved surface that is 5,000 square feet or greater used for the transportation of automobiles, trucks, motorcycles, and other vehicles 10. A?efa/7 Gasoline Outiets. Servino more than 100 vehicles per day and greater than 5,000 square feet 11. Coastal Development Zone. Anv proiect located within 200 feet of the Pacific Ocean and (1) creates more than 2500 square feet of impermeable surface or (2) increases impermeable surface on property by more than 10%. 12. Afore than 1-acre of disturbance. Proiect results in the disturbance of more than 1-acre or more of land and is considered a Pollutant-generating Development Project^. 1 Environmentally Sensitive Ai^as include but are not limited to all Clean Water Act Section 303(d) impaired water bodies; areas designated as Areas of Special Biological Significance by the State Water Resources Control Board (Water Quality Control Plan for the San Diego Basin (1994) and amendments); water bodies designated with the RARE beneficial use by the State Water Resources Control Board (Water Quality Control Plan for the San Diego Basin (1994) and amendments); areas designated as preserves or their equivalent under the Multi Species Conservation Program within the Cities and County of San Diego; and any other equivalent environmentally sensitive areas which have been identified by the Copermittees. 2 "Directly adjacent" means situated vwthin 200 feet of the Environmentally Sensitive Area. 3 "Discharging directly to" means outflow from a drainage conveyance system that is composed entirely of flows from the subject development or redevelopment site, and not commingled with flow from adjacent lands. 4 Pollutant-generating Development Projects are those projects that generate pollutants at levels greater than background levels. In general, these include all projects that contribute to an exceedance to an impaired water body or which aeate new impen/ious surfaces greater than 5000 square feet and/or introduce new landscaping areas that require routine use of fertilizers and pesticides. In most cases linear pathway projects that are for infrequent vehicle use, such as emergency or maintenance access, or for pedestrian or bicycle use, are not considered Pollutant-generating Development Projects if they are built with pervious surfaces or if they sheet flow to sun^ounding pen/ious surfaces. Section 1 Results: .If you answered YES to ANY of the questions above your project is subject to Priority Development Project requirements. Please check the "meets PRIORITY DEVELOPMENT PROJECT requirements" box in Section 3. A Stomi Water Management Plan, prepared in accordance with City Stomi Water Standards, must be submitted at time of application. If you answered NO to ALL of the questions above, then your project is subject to Standard Stomiwater Requirements. Please check the "does not meet PDP requirements" box in Section 3. E-34 Page 2 of 3 REV 4/30/10 STORM WATER Development Services Land Deveiopment Engineering CITY OF STANPARPS Development Services Land Deveiopment Engineering CITY OF QUESTIONNAIRE 1635 Faraday Avenue CARLSBAD E-34 760-602-2750 www.carlsbadca.gov SECTiON 2 SIGNIFICANT REDEVELOPMENT Complete the questions be\ow regarding your redevelopment project: YES NO 1. Project results in the disturbance of more than 1-acre or more of land and is considered a Pollutant-generating Development Project (see definition in Section 1). X If you answered NO, please proceed to question 2. If you answered YES, then you ARE a significant redevelopment and you ARE subject to PRIORITY DEVELOPMENT PROJECT requirements. Please check the "meets PRIORITY DEVELOPMENT PROJECT requirements" box in Section 3 below. 2. Is the project redeveloping an existing priority project type? (Priority projects are defined in Section 1) X If you answered YES, please proceed to question 3. If you answered NO, then you ARE NOT a significant redevelopment and your project is subject to STANDARD STORMWATER REQUIREMENTS. Please check the "does not meet PDP requirements" box in Section 3 below. 3. Is the project solelv limited to just one of the followinq: a. Trenching and resurfacing associated with utility woric? y b. Resurfacing and reconfiguring existing surface paricing lots? c. New sidewalk construction, pedestrian ramps, or bike lane on public and/or private existing roads? d. Replacement of existing damaged pavement? If you answered NO to ALL of the questions, then proceed to question 4. If you answered YES to ANY ofthe questions then you ARE NOT a significant redevelopment and your project is subject to Standard Stormwater Requirements. Please check the "does not meet PDP requirements" box in Section 3 below. 4. Will your redevelopment project create, replace, or add at least 5,000 square feet of impervious surfaces on an existing development or, be located within 200 feet of the Pacific Ocean and (1)create more than 2500 square feet of impermeable surface or (2) increases impermeable suri'ace on the property by more than 10%? % If you answered YES, you ARE a significant redevelopment, and you ARE subject to PRIORITY DEVELOPMENT PROJECT requirements. Please check the "meets PRIORITY DEVELOPMENT PROJECT requirements" box in Section 3 below. If you answered NO, then you ARE NOT a signiflcant redevelopment and your project is subject to STANDARD STORMWATER REQUIREMENTS. Please check the "does not meet PDP requirements" box in Section 3 below. SECTION 3 Questionnaire Results: My project meets PRIORITY DEVELOPMENT PROJECT (PDP) requirements and must comply with additional stormwater criteria per the SUSMP and must prepare a Storm Water Management Plan for submittal at time of appiication. My project does not meet PDP requirements and must only comply with STANDARD STORMWATER REQUIREMENTS per the SUSMP. Applicant Infonnation and Signature Box This Box for City Use Only Address: Assessor's Parcel Number(s): Applicant Name: Applicant Title: Applicant Signature: Date: City Concun-ence: By: YES NO Date: Project ID: E-34 Page 3 of 3 REV 4/30/10 City of Carlsbad 163 5 Faraday Avenue Carlsbad CA 92008 Applicant: ELIZABETH SPECK Description Amount CDP10032 615.00 880 CARLSBAD VILLAGE DR CBAD Receipt Number: R0082271 Transaction ID: R0082271 Transaction Date: 12/09/2010 Pay Type Metiiod Description Amount Payment Check 1058 615.00 Transaction Amount: 615.00 city of Carlsbad 163 5 Faraday Avenue Carlsbad CA 92008 lllllililllllllll Applicant: ELIZABETH SPECK Description Amount RP100046 3,205.00 880 CARLSBAD VILLAGE DR CBAD Receipt Number: R0082270 Transaction ID: R0082270 Transaction Date: 12/09/2010 Pay Type Method Description Amount Payment Check 1058 3,205.00 Transaction Amount: 3,205.00