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Home My WebLink AboutRP 14-19; Dana G's Boutique; Redevelopment Permits (RP) (2)CARLSBAD LAND USE REVIEW APPLICATION P-1 Planning Division 1635 Faraday Avenue (760) 602-4610 www.carisbadca.gov APPLICATIONS APPUED FOR: (CHECK BOXES) Development Permits I I Coastal Development Permit (*) | [Minor I I Conditional Use Permit {*) I [Minor [ [ I I Day Care (Large) (FOR DEPT. USE ONLY) Legislative Pennits (FOR DEPT. USE ONLY) Extension Environmental Impact Assessment Habitat Management Permit [ [Minor Hillside Development Permit (*) [ [Minor Nonconforming Construction Permit Planned Development Permit [ [Minor Minor [ [Residential [ [Non-Residential Planning Commission l3etermination Site Development Plan [ [ [ [ Special Use Permit [ [ Tentative Parcel IMap (Minor Subdivision) Tentative Tract Map (Major Subdivision) Variance [ j Minor neral Plan Amendment [ [Local Coastal Program Amendment (*) Master Plan I [specific Plan Zone Change (*) Amendment Amendment Zone Code Amendment Soutfi Carlsbad Coastal Review Area Permits Review Permit Administrative [ ^inor [ [Major Villaae Review Area Permits Review Permit ^ Administrative [ [Minor j [Major (*) = eligible for 25% discount NOTC: A PROPOSED PROJECT REQUIRING MULTIPLE APPLICATIONS MUST BE SUBMITTED PRIOR TO 3:30 P.M. A PROPOSED PROJECT REQUIRING ONLY ONE APPLICATION MUST BE SUBMITTED PRIOR TO 4:00 P.M. ASSESSOR PARCEL NO(S).: 23^^ S^/c SWee]r ^rlbba^. 3;iQo6 PROJECT NAME: BRIEF DESCRIPTION OF PROJECT: BRIEF LEGAL DESCRIPTION: OF PROJECT: 3-9 shk- SW^h (^rlfebacP ^O-cob STREET AADRESS OF i?VMrp.^- LOCATION ON THE: BETWEEN sou (NORTH, SOUTH, EAST, WEST) SIDE! AND (NAME OF STREET) (NAMEi p-1 Page 1 of 6 Revised 12/13 Aug 20 14 11.47a DanaG 760 7# 08 p.2 4 OWNmNAME (Print): MAIUNG AODRQSa CITY. STATE, Zl TaffHONE eviAlL ADDRESi APPUCANT NAME (Plint): T>anA ^ RcgJL MAIUNG ADDRESS; tjt^^ ^<r^>- CITY. STATE, ZIP: GAfj .^fo^d, P/V 6MAILA00RESS: da^axj bo«t.iiyi<.g)3b:^et»al ru-b I CERTIPT THAT I INFO,RMATK»l I KNOWLEDGE \M TVC LEGAL OWNER AND THAT ALL THE ABOVE TRLE ANDjCOftffCT TO THE BEST OF MY I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE OWNER AND THAT ALL THE ABOVE INFORMATION 6 TRUE ANO CORRECT TO OATE THE BEST OF MY APPLICANTS Rl MAILMG ADDRE }S CITY. STATE. ZII TELEPHONE: EMAIL AODRES; PRESENTATIVE (PrtT»: I CERTIFY THATi I fM THE LEGAL REPR£BH^rrA^^VE OF THE APPUCANT AND MAT ALL THE ABOVE INFORMATION IS TRUE AN} CORRECT TO THI BEST OF MV KNOWLEDGE SIGNATURE DATE M THE PROCB S COMMISSIONEF > APPLICATION. l|we OF RE\flB«ING TWtS APPLICATION IT MAY BE NECaESSARY FOR MEMBERS OF CmC STAFF. PLANNING OR crTY CCKINCIl MEMBERS TO INSPECT AND ENTER THE PROPgRTY THAT IS THE SUBJECT OF THIS CONSENT TO ENTRY FOR THIS PURPOSE. NOTICE OF RE! RECORDEO ON THE LAND AND TRICnON: PROPS^ OWNER ACKNOWLEDGES AND CONSENTS TO A NOTICE OF RESTRICTION BEING TITLE TO HI5?PR0EERTY JF CONDITIONED FOR THE APPLICANT. NOTICE OF RESTRICTIONS RUN WITH SEP 1 9 2014 DATE STAMP APPLICATION RECEIVED RECOVED BY: P-1 P«9a2of 6 Revised 12/13 06/18/2014 16; 38 FAX ^ A I|1003 iiHtemnHtertlon twt Intuwnc^ Rtouirainent w viiiayi Area AdnUntetratlve Permit CarmcaSon Statament I Certifv mat I am thft i aiain—Qmrnar of th« sut^ bmliWBs and that all of the abciv» informatton is true andSred to the b^Sm^SI^^^^ to accept and abide by any condKtona P>«»^«w orateet eft a weutt of approval of thi* applfcaBon. I agree to indwinify, hoW hannless. and *fend ttie Crty of cS^d and -Its officersand employees flwn ali daims. damage or lability to persons or property ateing from or Mi^dSdlJorhTdlrectly bytS iSSlatlon or placement of the saim proparty on tfta pubIC sidewalk anjjr the operation of the autijed businees on the publlo sWewaiK puniuarit to this pemift unl<»»» danwge oNteWhty wascawsedbytheaoteacavenegllgenceoftheCnyofCaitBba^ '^^'^^^'SSf Certificate of Insurance to the City of Cartsbed in the amount of one rrjiion doltera ^fJjg^Jj/Ji^r^'lSS has a rating in the latest "Bears Rating Guide* of "A-" of belter and a financial sae of $50-$100 Vil) or better which lists the City of Oerisbad as -add«ior»al insured" and provides P^mfJV^*);*^ ™ ^ I also agree to notliy the City of Carisbad thirty days prior to any caooellalton or axpWatlOfl of tna poBoy, The notice shafl be deUvBTBd toi City Planner City of Carisbad 1835 FaradayAvenue Carlsbad The insurance sM remain m effect tor as long as the property is placed on the P«*«? »Wtt»«ik^^ IS JeSted on the public sWewailc. Ttils agieaUt is a condition of tne issuance of this adminsj^ P^**^ theVubiect of this pwnit on the pubiic sidewalk, i understand that an wroj«d admir^b^ pem reniain inefltect for as iong as outdoor displays are perniitted wttrtn the Viilage Review Area and toe pennittee iwnains in compliahoe wfth ttieswbjedapproved pennit . ^jr>^^ y A Date: flf^jH SIgnalurs, CertfficaMon Statenionf: I Camftr that I am the Lami Pronertv Owner for the subject business tocatton and that aU or the above nfSw^ trw wtfw™ totoaSst^ my knowledga I support the appBcanTs request tor a peonit to SaS^STsutied iJSp^^ I undSrstand £at an approved adminittiatlva permit shall SSn in SSStor'^g Z outor displays are pernutted v«tNn toe VHIage Review Arae and tha pemttttee remains In complltf^virtto thd suMed ap^Moved permit ikk- p-1 pag«3of6 R«wiaBd12/13 A.CORtjr CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 09/17/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIOHTS UPON THE CERTtFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDfTIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the poiicy, certain policies may require an endorsemenL A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 858-391-8544 858-391-8546 Teiri Yurek Insurance Services 13240 Evening Creek Drive S Suite 305 San Dieqo, CA 92128 CONTACT v..r«i, NAME: Tem Yurek PRODUCER 858-391-8544 858-391-8546 Teiri Yurek Insurance Services 13240 Evening Creek Drive S Suite 305 San Dieqo, CA 92128 fflg.'tS,. ExB. 858-391 -8544 TAIC. NOI: 858-391 -8546 PRODUCER 858-391-8544 858-391-8546 Teiri Yurek Insurance Services 13240 Evening Creek Drive S Suite 305 San Dieqo, CA 92128 ADWIESS: terri@tenriyurekinsurance.com PRODUCER 858-391-8544 858-391-8546 Teiri Yurek Insurance Services 13240 Evening Creek Drive S Suite 305 San Dieqo, CA 92128 INSURER(S) AFFORDINO COVERAGE NAIC* PRODUCER 858-391-8544 858-391-8546 Teiri Yurek Insurance Services 13240 Evening Creek Drive S Suite 305 San Dieqo, CA 92128 INSURERA Travelers INSURED 760-729-3401 Dana Reed DBA: Dana G Boutk^ue 540 Grand Avenue Carlsbad.CA 92008 INSURER B INSURED 760-729-3401 Dana Reed DBA: Dana G Boutk^ue 540 Grand Avenue Carlsbad.CA 92008 INSURERC INSURED 760-729-3401 Dana Reed DBA: Dana G Boutk^ue 540 Grand Avenue Carlsbad.CA 92008 INSURER 0 INSURED 760-729-3401 Dana Reed DBA: Dana G Boutk^ue 540 Grand Avenue Carlsbad.CA 92008 INSURER E INSURED 760-729-3401 Dana Reed DBA: Dana G Boutk^ue 540 Grand Avenue Carlsbad.CA 92008 INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO AU THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUQES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF (MMTODrYYYY) POLICY EXP (MM«M»YYYY) LIMITS A / COMMERCIAL Gt •NERAL LIABILITY )E i 1 OCCUR I6806D096637 09/15/2014 09/15/2015 EACH OCCURRENCE $ 1.000.000 A 1 CLAIMS-MAC •NERAL LIABILITY )E i 1 OCCUR I6806D096637 09/15/2014 09/15/2015 DAMASETO REMTED PREMISES fEa oceurrencel s 300.000 A •NERAL LIABILITY )E i 1 OCCUR I6806D096637 09/15/2014 09/15/2015 MED EXP (/^y one person) $ 5.000 A I6806D096637 09/15/2014 09/15/2015 PERSONAL & ADV INJURY $1,000,000 A GEN'L AGGREGATE LIMIT APPLIES PS!: I6806D096637 09/15/2014 09/15/2015 GENERALAGGREGATE $ 2.000.000 A / POLICY 1 1 ^LOC OTHER: I6806D096637 09/15/2014 09/15/2015 PRODUCTS - COMP/OP AGG J 2.000.000 A POLICY 1 1 ^LOC OTHER: I6806D096637 09/15/2014 09/15/2015 s AUTOMOBILE LIABILITY c6MglN^DSll>j6L^ LIMIT fEa accident) % ANYAUTO BODILY INJURY (Per person) $ ALL OWNED ALTTOS HIRED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ ALL OWNED ALTTOS HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAGE fPer accident) $ ALL OWNED ALTTOS HIRED AUTOS $ UMBRELLA LIAB EXCESS LIAB OCCUR EACH OCCURRENCE $ UMBRELLA LIAB EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ % WORKERS COMPENSATION AND EMPLOYERS^ LIABILITY y / N ANY PROPRIETOR/PARTNER/EXECUTIVE 1 1 OFRCER/MEMBER EXCLUDED? (Mandatory in NH) ' ' If yes, describe under DESCRIPTION OF OPERATIONS below N/A PER OTH-STATUTE ER WORKERS COMPENSATION AND EMPLOYERS^ LIABILITY y / N ANY PROPRIETOR/PARTNER/EXECUTIVE 1 1 OFRCER/MEMBER EXCLUDED? (Mandatory in NH) ' ' If yes, describe under DESCRIPTION OF OPERATIONS below N/A E.L EACH ACCIDENT % WORKERS COMPENSATION AND EMPLOYERS^ LIABILITY y / N ANY PROPRIETOR/PARTNER/EXECUTIVE 1 1 OFRCER/MEMBER EXCLUDED? (Mandatory in NH) ' ' If yes, describe under DESCRIPTION OF OPERATIONS below N/A E.L DISEASE - EA EMPLOYEE % WORKERS COMPENSATION AND EMPLOYERS^ LIABILITY y / N ANY PROPRIETOR/PARTNER/EXECUTIVE 1 1 OFRCER/MEMBER EXCLUDED? (Mandatory in NH) ' ' If yes, describe under DESCRIPTION OF OPERATIONS below N/A E.L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional RemaiKs Schedule, may (» attached If more space Is required) AS RESPECTS TO GENERAL LIABILITY, CERTIFICATE HOLDER IS ADDITIONAL INSURED CERTIFICATE HOLDER CANCELLATION The City of Carlsbad 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. The City of Carlsbad 1 AUTHORIZED REPRESENTATIVE ® 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORO name and logo are registered marks of ACORD ^ DISCLOSURE STATEMENT Planning Division CITY or p <I/A\ 1635 Faraday Avenue CAR! SRAD (760602^610 ^ ivl-.,.) Ur~\ l-J www.carisbadca.gov Applicant's statennent 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, Comnnission or Committee. The following information iViUST 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. APPLiCANT (Not the applicant's agent) Provide the COiVlPLETE. 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 publiclv-owned corporation, include the names, titles, and addresses of the corporate officers. (A separate page may be attached if necessary.) Person " - i K ^ -' -l Corp/Part Title Title Address . i " ' i • ' • Address 2. OWNER (Not the owner's agent) Provide the COWiPLETE. 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, titles, addresses of all individuals owning more than 10% ofthe 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 Corp/Part Title Title Address Address p-1 (A) Pagel of 2 Revised 07/10 09/15/2014 16:38 FAI ^ ^ 2)002 3, NON-PROFIT ORGANIZATION OR TRUST if any p«ii&rH<k)Qtified purauant to (1) or (2) above is f npnptnft onMninrtion or a trust, list tbe names andlRWiW8 o* ^ P««0« as an olficer or director of the non- profit organization or as ttulieeuQrbenslteiwy of tlie. Non Prrrftf/Tnjst ^""^ NoR PTofitTrnja^ Title. AcWliie8s__ Addreat:^ 4, Have you had more then 9600 worth of isuslheas transacted with an^^member of Ctty staff, Boarde, Commiteiona. Comrnittees and/or Council wlthfei the past twelve (12) months? CD Yes n No if yes. please Inditsate person(s); NOTE: Attach additionai sheets'rf necessary. • infbnnatlon is tme and oonect to the best of my knowledge. ^ignetufs of applfcpnt/date Bitura of owner/date Prinf d type name of owner Print or type name of appHcant Signature of owner/applicanfs agent if applicable/date Print or type name of owner^ppiicanf a agent p,1{A) Pag«Zor2 RBVl6«IO7/10 I A 1 i--- - ^-^^ rck-L- SEP 1 9 ZOH