The URL can be used to link to this page

Home My WebLink AboutRP 15-02A; Barrel Republic; Redevelopment Permits (RP)· (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) Development Permits (FOR DEPT. USE ONLY) Legislative Permits (FOR DEPT. USE ONLY) ~-Coastal Development Permit(*) 0 Minor /5-0) A 0 Conditional Use Permit (*) 0 Minor 0 Extension D Day Care (Large) D Environmental Impact Assessment Habitat Management Permit D Minor D D D 0 ·Hillside Development Permit (*) 0 Minor Nonconforming Construction Permit Planned Development Permit 0 Minor 0 Residential 0 Non-Residential 0 Planning Commission Determination D Reasonable Accommodation 0 Site Development Plan 0 Minor 0 Special Use Permit 0 Tentative Parcel Map (Minor Subdivision) 0 Tentative Tract Map (Major Subdivision) 0 Variance D Minor 0 General Plan Amendment 0 Local Coastal Program Amendment (*) 0 Master Plan 0 Amendm1ent 0 Specific Plan 0 Zone Change (*) 0 Amendment 0 Zone Code Amendment South Carlsbad Coastal Review Area Permits 0 Review Permit 0 Administrative D Minor [] Major Village Review Area Permits :18( Review Permit ~Administrative D Minor []Major (*) = eligible for 25% discount MOTE: A PROPOSED PROJECT REQUIRI!IlG MULTIPLE APPLICATIOIIlS MUST BE SUBMITTED PRIOR TO 3:30P.M. A PROPOSED PROJECT REQUIRING ONLY ONE APPLICATION MUST BE SUBMITTED PRIOR TO 4:00P.M. LOCATIONOFPROJECT: zqsc'\ ~ e[:16\ ~ 1!1C?? STREET ADDRESS kJss-r SIDE OF 'S5r.AL~ <??t~ ON THE: (NORTH, SOUTH, EAST, WEST) (NAME OF STREET) BE1WEEN Gltr2i...k>e:AD \ h~ AND w~D .AiJs . (NAME OF STREET) (NAME OF STREET) t P-1 Page 1 of 6 Revised 07/15 OWNER NAME -(Print): MAILING ADDRESS: ~~~~~~~~~~~~ CITY, STATE, ZIP: TB_EPHONE: Sv'IAIL ADDRESS: I CERTIFY THAT I AM THE REPRESENTATIVE OF THE APPLICANT FOR PURPOSES OF THIS APPUCATION AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDG. SIGN APPLICANT NAME {Print): M£6 Z\~~ MMUNGADDRESS:~~j~ CITY, STATE, ZIP: .,.,-. -;1) 1 £·/ TELEPHONE: c;;.Lq ~4c: =?\:2....""'LP1 EMAIL ADDRESS: -A7 .. .1i2%4::$jt}J" :1?;.\L. I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BESl: F MY KNOWLEDGE. 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 11-IE PROPERTY THAT IS THE SUBJECT OF !HIS APPLICATION. 1/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 OPERTY IF CONDITIONED FOR THE APPLICANT. NOTICE OF RESTRICTIONS RUN '.'1/ITH THE LAND A D BIND ANY SU INTEREST. FOR CiTY USE ONLY P-1 Page2of6 REC:EIVED DEC 64 2015 ClTY OF CARLSBAD PLANNING 0\VISiON DATE STAMP APPLICATION RECEIVED RECEIVED BY: Revised 07/15 Indemnification and Insurance Requirement for Village Area Administrative Permit Certification Statement: I Certify that I am the Legal Business Owner of the subject business and that all of the above information is true I and correct to the best of my knowledge. I agree to accept and abide by any conditions placed on the subject ! project as a result of approval of this application. I agree to indemnify, hold harmless, and defend the City of Carlsbad and its officers and employees from all claims, damage or liability to persons or property arising from or caused directly or indirectly by the installation or placement of the subject property on the public sidewalk and/or the operation of the subject business on the public sidewalk pursuant to this permit unless the damage or liability was caused by the sole active negligence of the City of Carlsbad or its officers or employees. I have submitted a Certificate of Insurance to the City of Carlsbad in the amount of one million dollars issued by a company whtch has a rating in the latest "Best's Rating Guide" of "A-" or better and a financial size of $50-$100 (currently class VII) or better which lists the City of Carlsbad as "additional insured" and provides primary coverage to the City. I also agree to notify the City of Carlsbad thirty days prior to any cancellation or expiration of the policy. The notice shall be delivered to: City Planner City of Carlsbad 1635 Faraday Avenue Carlsbad The insurance shall remain in effect for as long as the property is placed on the public sidewalk or the business is operated on the public sidewalk. This agreement is a condition of the issuance of this administrative permit for the subject of this permit on the public sidewalk. I understand that an approved administrative permit shall remain in effect for as long as outdoor displays are permitted within the Village Revievl Area and the permittee remains in compliance with the subject approved permit. Signature _________________ _ Date: __________ _ Certification Statement: I Certify that I am the Legal Property Owner for the subject business location and that all of the above information is true and correct to the best of my knowledge. I support the applicant's request for a permit to place the subject property on the public sidewalk. I understand that an approved administrative permit shall remain in effect for as long as outdoor displays are permitted within the Village Review Area and the permittee remains in compliance ~ the sub· e~t. ved permit. Date: rJ2 -Ol.3.-d£J/?; P-1 Page 3of6 Revised 07/15 «~ ~ CITY 0~ DISCLOSURE STATEMENT P-1(A) Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.gov CARLSBAD 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 following 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, fraternal organization, corporation, estate, trust, receiver, syndicate, in this and any (>ther 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. 2. P-1(A) APPLICANT (Not the applicant's agent) Provide the COMPLETE. LEGAL names and addresses of Abb persons having a financial interest in the application. If the applicant includes a comoration or partnership, include the names, titles, addresses of all individuals owning more than 110% 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 publicly-owned \V corporation, include the names, titles, and addresses of the corporate o1fficers. (A / separate page ~ay be attached if necessary.) /) · Person ~\} 10 ?IKe; Corp/Part,L«l ( fV@Nl fr })wt;; Title Title_--.:::~-""!"7----_,.,------ Address 3~~~gf~L Address,~IO '.(l~ W~"~ ~? OWNER (rfot the owner's a&ent) r l :;.~ 0 t4 £..-o ~ :u Provide the COMPLETE. LEGAL names and addresses of ALL persons lhaving 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% 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 publicly-owned comoration, include the names, titles, and addresses of the corporate officers. (A separate page may be attached if necessary.) Person,L€01 Llli..fi! .ro Corp/Part Cef31sf:,gd ra~~;,e,.J,y Title Ovn.e.lj, Title marJC',?f)ef{ ·--- Address f->502 E c hCJIIOOn Address P50Z £ .. cha./)J1J/I(} Ai/.e :1(;1{/ <#~ltf "~~· o1t1Ptfe 0 4-t~ · 0~~11Je: C4 t:i!J.i't;q IJ Page 1 of2 Revised 07/10 ,. l 3. NON-PROFIT ORGANIZATION OR TRUST If any person identified pursuant to (1) or (2) above is a nonprofit organization or a trust, list the names and addresses of ANY person serving as an officer or director of the non- profit organization or as trustee or-beneficiary of the. Non Profitffrust ftl / ~ Non Profitffrust~M~fA~------ Title Title ____________ _ Address-_________ _ Address-__________ _ 4. Have you had more than $500 worth of business transacted with any member of City staff, Boards, Commissions, Committees and/or Council within the past twelve (12) months? 0 Yes ~No If yes, please indicate person(s):__, ________ _ NOTE: Attach additional sheets if necessary. P-1(A) Page 2of2 \ ----~.~ ~JD Bt<t ~rint or type name of applicant Revised 07/10 City of Carlsbad PROJECT DESCRIPTION P-1(8) Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.gov PROJECT NAME: -----lz~jL--.IO·(,~p~t:...!.~-=e.~·l.,-.:.____0.JL..:~.L.<~~v~~~,,l\~.~....:::../ _____ _ APPLICANT NAME: __ _____..!,.:;r..!,_~;_!·· ~:___tJr.<;;:.--l!l\@;.,:::..·{L_...l!...!.~------- 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: ~~i'V~ 16 A~j...SD "TKe. ~<e>--rtl'4 Affl~ Cl)-p \-s ~ o Z ---r?J (i.Je.::(?£.ACS.Ii3 -v-iE ~ ~--W/ -uJs A\1?~\tLOW oF A-t::UA~ 't:L)[T-£:,. -ro -rt-ts ~A! P-1(8) Page 1 of 1 Revised 07/10 (cicyof Carlsbad HAZARDOUS WASTE AND SUBSTANCES STATEMENT P-1(C) Development Services Planning Division 1635 Faraday Avenue (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): D 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: .A~ 1: L~~ Name: LAfl$8-1) UiLi.4ql;{>A~~ Address: ~dn k:Jt.J\.)N~,D.A~ddress:'13SD~ E,De?T'cJ4MV\'\MJ~ ~ :ct~p U\. Of1-ll7 OM)\)Sf:: ;u' qzgc;1 :PGI4· Phone Number: & lA ~ q21S1 Phone Number: 7l~ ??iG::- AddressofSite: zg s·q 4-: zqeot ~-z_0 co3 ?"fAJ";S . 71:4, Local Agency (City and County): CA-ti. .. $1f:?.A.D bAA)JV\t;=(_..p Assessor's book, page, and parcel number: ?;tJ ~ ·• 1..fl? · 04 -0'0 Specify list(s): _____________________________ _ Regulatory Identification Number: _______ -:----------------- Date of List: ______________________________ _ Property Owner Signature/Date The Hazardous Waste and Substances Sites List (Cortese List) is 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. P-1(C) Page 1 of2 Revised 02/13 CARLSBAD HAZARDOUS WASTE AND SUBSTANCES STATEMENT P-1(C) Development Services Planning Division 1635 Faraday Avenue (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, f have consulted the Hazardous Waste and Substances Sites List compiled by the California Environmental Protection Agency and hereby certify that (check one): '(]I 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. 0 The development project and any alternatives proposed in this application !!! contained on the lists compiled pursuant to Section 65962.5 of the State Government Code. Assessor's book, page, and parcel number: ___________________ _ Specify list(s): _____________________________ _ Regulatory Identification Number: ___________________ , ____ _ The Hazardous Waste and Substances Sites List (Cortese List) is used by thE!i 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. P-1(C) Page 1 of2 Revised 02/13