HomeMy WebLinkAboutSA 16; GERICOS; Satellite Antenna Permit (SA),
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SATELLITE ANTENNA PERMIT
ocation
Assessors Parcel Number 20'1-&&r:J. -3
Zone Exi~ting Land Use
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Owner A licant
Name (Print or Type) m/leR-flrJ Name (Print or TyPe)
Gli.gJ~~AL
Mailing Address
City and State Zip Telephone city and State Zip Telephon
I CERTIFY THAT I AM THE LEGAL OWNER AND I AM THE OWNER'S REPRESENTATIVE
THAT ALL THE ABOVE INFORMATION IS TRUE AND THAT ALL THE ABOVE INFORMATION IS TRUE
AND CORRECT TO THE BEST OF MY ~OWLEDGE. AND OORRECT TO THE BEST OF MY KNOWLEDGE.
DATE DATE
3-d?-'h?
Received By Received Receipt No.
ate Application Rec'd Staff Assigned Case Number
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Specific Requirements
1. Two (2) copies of site plan showing:
cross sections showing adjacent properties and streets
~ distances between buildings and/or structures and satellite antenna
building setpaQks (front, rear and sides)
location, height, and materials of walls and fences
2. Two (2) copies of landscape plan showing:
types of plants and their sizes
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3. Two (2) copies of elevations showing:
height of satellite antenna, landscaping and/or fence/wall
4 • $ 2 5 • 0'0 Fee
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.. CITY OF CARLSBAD ..
1200 ELM~ENUE CARLSBAD, CALlF~IA 92008
438·5621
REC'D FROM_-",-(",-~~_-{'7_I_(_-~"_6_' _\ ______________ DATE_---=-·)-r-/;-+I_J-4-/ /--'(""-:\ r-l __
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ACCOUNT NO. DESCRIPTION AMOUNT
0012 J\5./'C1' (1 i {\-; .,' .. j;~~ ... -; --
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RECEIPT NO. 72707 TOTAL ')"-'C-'() ("'; ... I