HomeMy WebLinkAboutRP 90-04; Roosevelt Center; Redevelopment Permits (RP)• 1 l" W CITY OF CARLSBAD
LAND USE REVIEW APPLICATION FORM PAGE 1 OF 2
1) APPLICATIONS APPLIED FOR: (CHECK BOXES)
(For Dept.
Use Only) (For Dept.
Use Only)
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Master Plan
Specific Plan
Precise Development Plan...
Tentative Tract Map
Planned Development Permit
Non-Residential Planned
Development Permit
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Condominium Permit
Special Use Permit,
^ Redevelopment Permit.
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Tentative Parcel Map
Administrative Variance
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General Plan Amendment
Site Development Plan
Zone Change
Conditional Use Permit
Hillside Development Permit.
Environmental Impact
Assessment
Variance
Planned Industrial Permit...
Coastal Development Permit..
Planning Commission Deter...
2) LOCATION OF PROJECT: ON THE
(NORTH, SOUTH, EAST, WEST)
OF
(NAME OF STREET)
BETWEEN AND
(NAME OF STREET) (NAME OF STREET)
3) BRIEF LEGAL DESCRIPTION: 13, SS'^ cyfi^^/iP/£ /^/?J /A/ 7^
(?.rr Q/^c^i/$^/p ^ /%^^ /7"xx cAv^ J^4^ ^fi<*^rY yM/zi
4) ASSESSOR PARCEL NO(S).
5) LOCAL FACILITIES
MANAGEMENT ZONE
6) EXISTING GENERAL
PLAN DESIGNATION
7) PROPOSED GENERAL
PLAN DESIGNATION
8) EXISTING ZONING 9) PROPOSED ZONING 10) GROSS SITE
ACREAGE
11) PROPOSED NUMBER OF
RESIDENTIAL UNITS
/\/r/^ 12) PROPOSED NUMBER
OF LOTS /l/r4 13) TYPE OF
SUBDIVISION
14) NUMBER OF EXISTING RESIDENTIAL UNITS
(RESIDENTIAL
COMMERCIAL
INDUSTIRAL)
15) PROPOSED INDUSTRIAL
OFFICE/SQUARE FOOTAGE
16) PROPOSED COMMERCIAL
SQUARE FOOTAGE
ARFM0008.DH 4/89
CITY OF CARLSBAD
LAND USE REVIEW APPLICATION FORM PAGE 2 OF 2
17) PERCENTAGE OF PROPOSED PROJECT IN OPEN SPACE
18) PROPOSED SEWER USAGE IN EQUIVALENT DWELLING UNITS
19) PROPOSED INCREASE IN AVERAGE DAILY TRAFFIC
20) PROJECT NAME:
21)BRIEF DESCRjPTIONJF PROJECT: [ ^/yg^ (j^/^jyUt U/^7W^ Q^J^$—/fyAK^^t^ryJ ' •
dur
22) OWNER
(PRINT OR TYPE);^ooJ'^t/^r
MAILING ADDRESS Y^AL^O /^^ry/SS
23) APPLICANT
NAME NAME (PRINT OR TYPE)
MAILING ADDRES
CITY AND STATE ^ ZIP TELEPHONE
I CERTIFY THAT I AM THE LEGAL OWNER AND THIAI-ALL THE ABOVE INFORMATION IS TRUE AND CORRECT
CITY AND STATE ZIP TELEPHONE
TO THE BEST OF MY KNOWLEDGE. SIGNATURE DATE
I CERTIFY THAT I AM THE OWNER'S REPRE-SENTATIVE AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT Ii
THE BEST OF MY KNOWLEDGE,
SIGNATURE .,-^-tJATE
**** **************************************************
FOR CITY USE ONLY
FEE COMPUTATION:
APPLICATION TYPE FEE REQUIRED
RECEIVED BY:
TOTAL FEE REQUIRED
DATE FEE PAIDI 7. ^ -^0 RECEIPT NO.
ARFM0008.DH 4/89^
City of qiarlcthp,^
DISCLOSURE STATEMENT
APPUCANTS STATEMENT OF DISCLOSURE OF CERTAIN OWNERSHIP INTERESTS ON ALL APPUCATIONS
WHICH WILL REQUIRE DISCRETIONARY ACTION ON THE PART OF THE CITY COUNCIL OR ANY APPOINTED
BOARD. COMMISSION OR COMMITTEE.
(Please Print)
The following information must be disclosed:
1. Applicant
Ust the names and addresses of all persons having a ftnanciai interest in the application.
Sf/r\ /^e-rA/yiTV ^ ^ ^y ^'"^ Oiut^^ . ^Zz^<
2. Owner
Ust the names and addresses of ali persons having any ownership interest in the property involved.
3. If any person identified pursuant to (1) or (2) above is a corporation or partnership, list the names ar
addresses of all individuals owning more than 10% of the shares in the corporation or owning any partnersh
interest in the partnership. /p
if any person identified pursuant to (1) or (2) above is a non-profit organization or a trust, list the names ar
addresses of any person serving as officer or director of the non-profit organization or as trustee or beneficia;
of the trust. , , • A/c? •
Disdosure Statement Page 2
Have you had more than $250 worth of business transacted with any member of City staff, Bcarc
Commissions, Committees and Council within the past twelve months?
Yes No 2^ If yes, piease indicate person(s) N, /Q y
Person is defined as: 'Any individual, firm, copartnership, joint venture, association, social club, fraternal
organization, corporation, estate, trust, receiver, syndicate, 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.*
(NOTE: Attach additional pages as necessary.)
Signature pf Owner/dat^ \
Print or type name of owner
Signature of appiicant/date
Print or type name of applicant