HomeMy WebLinkAbout20190621_ApplicationCommunity Development Department
Planning Permit Application
1. Check Permits Requested:
D Approval-in-Concept -AIC # D Lot Merger
D Coastal Development Permit D Limited Term Permit -
D Waiver for De Minim is Development D Seasonal D < 90 day 0>90 days
D Coastal Residential Development D Modification Permit
D Staff Approval
D Tract Map
D Traffic Study
p(, Use Permit -·~Minor Oconditional
D Condominium Conversion D Off-Site Parking Agreement
D Comprehensive Sign Program D Planned Community Development Plan
D Amendment to existing Use Permit
D Variance
D Development Agreement D Planned Development Permit
D Development Plan D Site Development Review -D Major D Minor
D Amendment -OCode OPC OGP OLCP
D Other:
D Lot Line Adjustment D Parcel Map
2. Project Address(es)/Assessor's Parcel No(s)
I too w e'>T ~i"~l t~'f. ~ 1J,
3. Project Description and Justification (Attach additional sheets if necessary):
A&o'-'\, 300 sc.> Fr of VJ)<>Nr ~~ Ne->c.r -;v X~"' ~~
11~ °"" tJ E:-I) ,.. 11'-e f2.tt TA I\ '-"' I).. .J 1o O C ,.., ~
4. Applicant/Company Name I 'T]J-e i::,e Stly..J 'JGl>r.A I
'J
4 l '2. ~~t/N c...{lt"',7 DfL. I Mailing Address Suite/Unit
City I C,.o tl,OtJ ~ State .---I -C-/)..--. --, Zip I a, Z...!, '1 Z.. I
Phone l ?iq-11-,-5iJj Fax ~---Email lh'\o.~ool?_1')\,.i.ew,.@ Arr,,~
5. Contact/Company Name I MA Soo D /'I) t ~ I
Mailing Address I Sf:\MJE ~ ~ f>r EcNc Suite/Unit -'---------''
City ~--------------~ State .---------, Zip '---------'I
Phone j 7 11' -7 <f. s-S-f,]<J Fax i------, Email ~------------'
6. Owner Name I ~,. W\ Pr N fl.&f A~ J I
vl1-Suite/Unit .--------, Mailing Address I J 1-( '2.. ~t-J'ro .-..a Cj'le ST
City I (;.QtP-t, t.1 Q ~ I State .--1 -o\-. --, Zip I Fi~ 2. I
Phone ~---------' I II Fax '----------' Email -------------~
7. Property Owner's Affidavit*: (I) (We)----------------------~
depose and say that (I am) (we are) the owner(s) of the property (ies) involved in this application. (I) (We) further
certify, under penalty of per'ury, that the foregoing statements and answers herein contained and the information
herewith submitted are · all re cts true and correct to the best of (my) (our) knowledge and belief.
Si QWc:lfure(s ): --+--I--~~----Title: I (') w tJe fl-I Date: I a. ~. l ~ I c._ , DD/MO/YEAR
*May be signed by the lessee or by an authorized agent if written authorization from the owner of record is filed concurrently with the
application. Please note, the owner(s)' signature for Parcel/Tract Map and Lot Line Adjustment Application must be notarized.
F:\Users\CDD\Shared\Admin\Planning_Division\Applications\Application_ Guidelines\Planning Permit Application -CDP added.docx Rev : 01 /24/17
PA2019-122