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Home My WebLink AboutV 02-03; Arco AM/PM at Tamarack; Variance (V)I - CITY OF CARLSBAD LAND USE REVIEW APPLICATION APPLICATIONS APPLIED FOR: (CHECK BOXES) I 4142 Adams Avenue TELEPHONE Administrative Permit - 2nd Dwelling Unit Administrative Variance Coastal Development Permit Conditional Use Permit . Condominium Permit Environmental Impact Assessment General Plan Amendment Hillside Development Permit Local Coastal Plan Amendment 9089 Clairemont Mesa Boulevard Suite #300 CITY AND STATE ZIP TELEPHONE (FOR DEPARTMENT USE ONLY) San Dieeo. CA 92130 (619) 300 - I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE KNOWLEDGE. - INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY IU 9031- ni~y. CA 931 31 (858) 278-11b1 I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE INFORMATION IS TRUE AND 7-27-01 0 0 0 Master Plan Non-Residential Planned Development Planned Development Permit Planned Industrial Permit Planning Commission Determination Precise Development Plan Redevelopment Permit Site Development Plan Special Use Permit Specific Plan Obtain from Engineering Department Tentative Tract Map Variance Zone Change List other applications not (FOR DEPARTMENT USE ONLY t I I I specified I 2) ASSESSOR PARCEL NO(S1.: 204-292-24 3) PROJECT NAME: ARC0 AM/PM at Tamarack 4) BRIEF DESCRIPTION OF PROJECT: Construction of new 2880 SF convenience store and 5760 SF canopy with gas dispensers Saad Attisha ~ pk STATE ZIP SIGNATURE DATE I SIGNATURE DATE J 7) BRIEF LEGAL DESCRIPTION Lot 1 of map no. 5944 NOTE: A PROPOSED PROJECT REQUIRING MULTIPLE APPLICATIONS BE FILED, MUST BE SUBMlmED PRIOR TO 3:30 P.M. A PROPOSED PROJECT REQUIRING ONLY ONE APPLICATION BE FILED, MUST BE SUBMITTED PRIOR To 4:OO P.M. PAGE 1 OF 2 Form 16 / 8) LOCATION OF PROJEC I : - 810 Tamarack Avenue STREEI A ,RESS BETWEEN Interstate 5 - __ I SIDE OF 1 Interstate 5 ON THE West I I (NORTH, SOUTH, EAST, WEST) (NAME OF STREET) AND Jefferson Street 9) LOCAL FACILITIES MANAGEMENT ZONE I \ 1 12) PROPOSED NUMBER OF I”/A? RESIDENTIAL UNITS 10) PROPOSED NUMBER OF LOTS IN/Al 1 1 ) NUMBER OF EXISTING RESIDENTIAL UNITS 14) PROPOSED IND OFFICE/ Ll 15) PROPOSED COMM IN/Al SQUARE FOOTAGE SQUARE FOOTAGE 17) PROPOSED INCREASE IN 122801 181 PROPOSED SEWER ADT USAGE IN EDU 20) EXISTING GENERAL 13) TYPE OF SUBDIVISION I 16) PERCENTAGE OF PROPOSED PROJECT IN OPEN SPACE F1 21) PROPOSED GENERAL 1.851 PLAN PLAN DESIGNATION 19) GROSS SITE ACREAGE 22) EXISTING ZONING pl23) PROPOSED ZONING 24) IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE NECESSARY FOR MEMBERS OF CITY STAFF, PLANNING COMMISSIONERS, DESIGN REVIEW BOARD MEMEBERS OR CITY COUNCIL MEMBERS THAT IS THE SUBJECT OF THIS APPLICATION. I/WE CONSENT SIGNATURE FOR CITY USE ONLY FEE COMPUTATION I TOTAL FEE REQUIRED I - 5- 1 / / DATE FEE PAID 1 7/3l,hf 1 RECEIVED BY: RECEIPT NO. - Form 16 PAGE 2 OF 2 City of Carlsbad 1635 Faraday Avenue Carlsbad CA 92008 Applicant : TAIT AND ASSOCIATES Description V02 0 0 0 03 Amount 1,860.00 Receipt Number: ROO28099 Transaction Date: 06/26/2002 Transaction Amount: 1,860.00 DISCLOSURE STATEMEXT Applicant’s statement or disclosure of certain ownership interests on all applications uh.ch \vi11 requrrc ; discretionary action on the pan of the City Council or any appointed Board. Commission or Committee. 1 The following information MUST be disclosed at the time of application subminal. Sour project cannot be reviewed until this information is completed. Please print. .. 1Yote: Person is defmed as “Any individual, fxnn, co-pannership, joint venture, association. social club. fraternal organization, corporation, estate, nust, receiver, syndicate. in this and any other county. ciy and counr)., civ 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 COMPLETE. LEGAL names and addresses of && persons having a financial interest in the application. If the applicant includes a comoration or uarmershiu. include the names, title, addresses of all individuals owning more than 10% of the shares. IF NO APPLICABLE W/A) M THE SPACE BELOW If a publiclv-owned comoration, include the names, titles, and addresses of the corporate officers. (A separate page may be attached if necessary.) 3 Person N/A Corp/Pad ARC0 Products Company INDIVIDUALS OWN MORE ’I” 10% OF THE SHARES, PLEASE INDICATE NON- Title Title Address Address 4 Centerpointe Drive La Palma, CA 90623 2. OWNER (Not the owner’s agent) Provide the COMPLETE. LEGAL names and addresses of && persons having any ownership interest in the property involved. Also, provide the nature of the legal ownership (Le, partnership, tenants in common, non-profit, corporation, etc.). If the ownership includes a comoration or uartnershiu, include the names, title, 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 comoration, include the names, titles, and addresses of the corporate officers. (A separate page may be attached if necessary.) Person Saa d Attisha CoqdPart Title Owner Title Address 4142 Adams Avenue Address San Diego, CA 92130 1635 Faraday Avenue 0 Carlsbad, CA 92008-737 4 0 (760) 6024600 FAX (760) 602-8559 @ If any person id Fed pursuant to (1 ) or (2) above is names and.addrei organization or as trustee or beneficiary of the. Non Profiflrust N/A Eon ProfitTrust Title Title Address Address -. I organ~zaiion or 3 ITUF:. iw ::.:;. of k.W‘ person senring as an offictl or director of the non-profi! - 4. Have you had more than $250 worth of business transacted with any member of CiF staff. Boards, Commissions, Committees andor Council within the past twelve (12) months? Yes No If yes, please indicate person(s): NOTE: Attach additional sheets if necessary. I certify that all the above infomation is true and correct to the best of my knowledge. Signature of owncr/date Print or type name of owner P.. \- L-y;& Signaturi of applicaddate ~ ~ Print or type name of applicant I Signature of owncr/applicant’s agent if applicable/date Leslie Burnride, Agent Print or type name of ownerlapplicant’s agent H:ADMIN\COUNfERDISCLOSUFE STATEMENT 5/98 Page 2 of 2 i I i i j- I I I I I ! I' ! I 1 ! I i ! 1 i i ! i I I I .'. . ........ ........ .,.. .. , - * : .. -. 4. .- , .... ... . .- I. a .-. .. .. * .. - . e., i ' '. .,. ! '. !' .I RECEIVED JUL-31-2001 12:lOPU FW61R 283 E627 .. -, .. I. TO-TAIT AND ASSOCIATES PACE 003