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HomeMy WebLinkAboutItem 3 - Attch 4 - Disclosure StatementCrIY OF CHM VIVA Type of Review Requested �✓ Conditional Use Permit L] Variance ❑ Design Review ❑ Misc, _.. Application Information Orf D, e v e I o p m e n t S e r v i c e s D e p a r t m e n t Planning Division I Development Processing APPLICATION Type A Part 1 —Applicant Name Verizon Wireless Applicant Address 15505 Sand Canyon Ave., Building D, First Floor, Irvine CA 92696 V Contact Name Shawn Grace Phone 760-707-2093 Applicant's Interest in Property (If applicant is not the owner, the owner's authorization signature at the end of this form is required to process this request,) Own ❑ Rent © Other Architect/Agent . PlanCom, Inc. Address 302 State Place, Escondido. CA 92029 Contact Name Shelly Kilbourn phone 619-208-4685 Primary Contact is; ❑ Applicant 0 Architect/Agent E-mail of primary contact shell kilbourn@cox.net Hazardous Waste and Substances Statement Hazardous Waste and Substances Statement - Section 65962,5f of the State of California Government Code requires that, before the City of Chula Vista accepts as complete an application for any development project, the applicant submit a signed statement indicating whether or not the project site is identified on the state of California Hazardous Waste and Substances Sites List, This list identifies known sites that have been subject to releases of hazardous chemicals, and is available at http://www.dtsc.ca.gov/SiteCleanup/Cortese_List.cfm. The development project and any alternatives proposed in this application ( ) is ( is not contained on the lists compiled pursuant to Section 65962.5 of the Government Code. If Yes, pro4riod Regulatory Identification Number; Date of List: Historical Resources The year(s) all structures were constructed on the property VZW L_ ightstands 2000; Church building If property is designated historical, provide Site # I certify that the information above is correct and accurate to the best of my knowledge. I understand that the project will be reviewed based on the Information provided Print Name Shell A. Kilbourn Signature General Project Description (all types) Date 2-22-16 Project Name Verizon Wireless North Chula Vista Proposed Use Modifications to a wireless communication facility Project Description Replace exisiin II htstand with a 35 foot mann ine io house the oxistin re lacemont wirless communication facility, Has this project received pre -application review comments? ❑ Yes (Date) ©No Subject Property Information (all types) Location Street Address 580 Hilftop Drive _ Parcel # 569-381-02 Total Acreage General Plan Designation Res .— Zone Classification Planned Community (ifaplicable) _. 10f9 Redevelopment Area (if applicable) Current Land Use Church and wireless communication facility Fann 276 f=ourth Avenue I Chula Vista I California 1 91910 I (619) 691.5101126 Rev D7,14 Attachlment 4 CITY OF CHUTA VISM D e v- e I o p m e n t S e r v i c e s D e p a r t m e a t Planning Division I Development Processing ° APPLICATION Type A Part 1 Type of use proposed ❑ Residential Landscape Coverage (% of lot) N/A Residential Project Summary ❑ Commercial © Industrial Building Coverage (% of lot) NIA Type of dwelling unit(s) Number of lots Dwelling Units PROPOSED EXISTING 1 Bedroom 2 Bedroom 3+ Bedroom TOTAL Density (DU/acre) Maximum building height, Minimum lot size Parking Spaces Required Provided Type of parking (i,e, size; covered, etc.) Open Space description (acres each private, common, and landscaping) Non -Residential Project Summary ❑ Mixed Use Average lot size Gross f=loor Area NIA Proposed No change Existing Building Height 35 ft Hours of operation (days & hours) Unmanned wireless facilty Anticipated number of employees NIA Maximum number of employees at any one time N/A Number and ages of students/children (if applicable) NIA Seating capacity NIA Parking Spaces Required NIA Provided NIA Type of parking (i,e, size; covered, etc.) Authorization Print applicant name Verizon Wireless See Attached Letter of Consent Applicant Signature _._ Date Print owner name* St, Marks Evangelical Lutheran Church - See Attached Lette of Consent Owner Signature* Date * Note; Proof of ownership may be required. Letter of consent may be provided in lieu of signature. ram 2of9 sTa 276 Fourth Avenue I Chula Vista California 1 91910 1 (619) 691,5101 RC1°7.74 Type of Review Requested ® Conditional Use Permit ❑ Variance ❑ Design Review El misc. Application Information D e v e l o p m e n t S e r v i c e s D e p a r t m e n t Planning Division I Development Processing APPLICATION Type A Part 1 STAFF USE ONLY Case YQc, J oo01 Filing Date: By. Project Manager., j ACA, ? Pll6T� Project Account. -lb& -a-a Depositkcaunt - IV Related Cases: ❑ Z.A. 14 Public Hearing Applicant Name _Verizon Wireless. L_LC c(o Brian Cook—Associites� nc. Applicant Address -4026 Hary treet, Suite n, San Diego. CA - Contact Name Chris Terry„ __ - Phone Applicant's Interest in Property (If applicant is not the owner, the owner's authorization signature at the end of this form is required to process this request.) Own ❑ Rent ® Other Architect/Agent Brian Cook &Associates, Ilac ` Address 4026 Hawk Street, Suite D, San Diego, CA 92103 Contact Name Chris Terf �' — �,� Phone _,(612.260-Q�.1�. _ Primary Contact is: Applicant ® Architect/Agent E-mail of primary contact _C_hrLS@h'janco, t xndms)_caCes•cc�fn Hazardous Waste and Substances Statement Hazardous Waste and Substances Statement - Section 65962.5f of the State of California Government Code requires that, before the City of Chula Vista accepts as complete an application for any development project, the applicant submit a signed statement indicating whether or not the project site is identified on the state of California Hazardous Waste and Substances Sites List, This list identifies known sites that have been subject to releases of hazardous chemicals, and is available at http://www.dtsc.ca.gov/SiteCleanup/Cortese_List.cfm. The development project and any alternatives proposed in this application ( ) is (X ) is not contained on the lists compiled pursuant to Section 65962.5 of the Government Code. If Yes, provide Regulatory Identification Number: _ Date of List: Historical Resources The year(s) all structures were constructed on the property If property is designated historical, provide Site 1< I certify that the information above is correct and accurate to the best of my knowled �I und stand that the project wIII be reviewed based on the information provided Print NameSignatureTe�'ty Signature �._ Date �',�/r✓/LJ General Project Description (all types) Project Name _-Norfi}1ClLtila Vi�t�_ Proposed Use ?I Project Description-C2r12t-iU-CtiLn�t�_s1�.5-icLQt faux pine-tr�e it aq&L Has this project received pre -application review comments? ❑ Yes (Date) Subject Property Information (all types) rxNo Location Street Address 5N H1(1to_p Drive Parcel 8 56-38LQ2�_, Total Acreage 2.5�Redevelopment Area (if applicable)No- General Plan Designation Zone Classification - R-1, Residei]tia1 _ _ -- Planned Community (if aplicable) 111+3 Current Land Use C:hULch/Wit'eless F Farm 320 276 Fourth Avenue I Chula Vista I California I 91910 eevaa.o I (619) 691.5101 Pg uz D e v e I o p rn e n t S e r v i c e s D e p a r t m e n t r_ Planning Division I Development Processing 5.:17Y'C3r - C.HULAVtS'1A APPLICATION Type A Part z Type of use proposed ❑ Residential Landscape Coverage (ok of lot) Residential Project Summary Type of dwelling unit(s) ® Commercial ❑ Industrial Building Coverage (°/a of lot) Dwelling Units PROPOSED EXISTING 7 Bedroom 2 Bedroom �. 3+ Bedroom TOTAL Density(DU/acre) Maximum building height Number of lots ❑ Mixed Use Minimum lot size_.w Average lot size Parking Spaces Required Provided . Type of parking (i.e. size; covered, etc.) _ Open Space description (acres each private, common, and landscaping)_ Non -Residential Project Summary Gross Floor Area _ Proposed Hours of operation (days & hours)_ Anticipated number of employees Number and ages of students/children (if applicable) Parking Spaces Required _ Provided Type of parking (i.e, size; covered, etc.)., Authorization Existing Building Height Maximum number of employees at any one time Seating capacity _ _ Print applicant name Verizon Wireless, LIC c/o Brian Coote & Associates, Inc. X "-1 Applicant Signature _ Date Print owner name` Saint Mans Evangelical Lutheran Church Owner Signature*pfl cl / bate * Note; Proof of ownership may be required. Letter of consent may be provided in lieu of signature, Form 370 Rev04.10 - 276 Fourth Avenue I Chula Vista California 1 91910 1 (619) 691.5101 Pg uz r D e v e l o p m e n t S e r v I c e s D e p a r t m e n t CHY()�f w Planning Div€sion f Development Processing l:nY () t`a'i€JCA VISA APPLICATION APPENDIX A Project Description & Justification Project Name .._North Cbula Vista Applicant Name T.Veriz...on Wireless LLC Please fully describe the proposed project, any and all construction that may be accomplished as a result of appl•oval of this project, and the project's benefits to yourself, the property, the neighborhood, and the City of Chula Vista. Include any detailsnecessary to adequately explain the -scope and/or operation of the -proposed project, You may include any background -information and supporting statements regarding the reasons for, or appropriateness of, the application, Use an addendum sheet if necessary, For all Conditional Use Permits and Variances, please address the required "findings" as listed -in the Application Process applicable guides. Moification toa � existin i Mess elecommunication facility col. sistingof the folio jig: ReRlaceexisting paz�lcing light standard with a35 -foot high faux ine ti ee housn% 12 acid anteiina�__ 12 remote radio units RRUs), 1 demarcation box, and associated anent inside an existing shelter. M 275 Fourth Avenue Chula Vista California 1 91910 (519) 591.5101 i D e v e l o p m e n t S e r v i c e s D e p a r t m e n t Planning Division I Development Processing 4.'M OF CliULAVISA APPLICATION APPENDIX B Disclosure Statement Pursuant to City Council Policy 101-01, prior to any action on a matter that requires discretionary action by the City Council, Planning Commission or other official legislative body of the City, a statement of disclosure of certain ownerships, financial interest, payments, and campaign contributions must be filed. The following information must be disclosed: 1. List the names of all persons having a financial interest in the project that is the subject of the application, project or contract (e,g., owner, applicant, contractor, subcontractor, material supplier). Saint Marlu Evangelical Lutheran Church 2. If any person* identified in section 1, above is a corporation or partnership, list the names of all individuals with an investment of $2000 or more in the business (corporation/partnership) entity. 3. If any person* identified in section 1, above is a non-profit organization or trust, list the names of any person who is the director of the non-profit organization or the names of the trustee, beneficiary and trustor of the trust, 4. Please identify every person, including any agents, employees, consultants, or independent contractors, whom you have authorized to represent you before the City in this matter. Brian Cook & Associates Inc, 5. Has any person *identified in 1., 2., 3., or 4., above, or otherwise associated with this contract, project or application, had any financial dealings with an official" of the City of Chula Vista as it relates to this contract, project or application within the past 12 months? Yes No X.-,__ If yes, briefly describe the nature of the financial interest the official** may have in this contract. Z X 276 Fourth Avenue Chula Vlsta California I 9199 p (619) 591,5101 t ( D e v e I o p m e n t S e r v I c e s D e p a r t m e n t 2 Planning Division I Development Processing CHY ni :LUL,\VISTA APPLICATION APPENDIX B Disclosure Statement - Page 2 6. Has any person *identified in 1., 2., 3,, or 4., above, or otherwise associated with this contract, project or application, made a campaign contribution of more than $250 within the past (12) months to a current member of the City of Chula Vista Council ? Yes m No X if yes which council member? 7. Has any person *identified in 1„ 2., 3., or 4., above, or otherwise associated with this contract, project or application, provided more than $420 (or an item of equivalent value) to an official** of the City of Chula Vista in the past (12) months? (This includes any payment that confers a personal benefit on the recipient, a rebate or discount In the price of anything of value, money to retire a legal debt, gift, loan, etc.) Yeses_ No If yes, which official** and what was the nature of -the Item provided? 8. Has any person identified in 1„ 2„ 3., or 4„ above, or otherwise associated with this contract, project or application, been a source of income of $500 or more to an official" of the City of Chula Vista in the past (12) months? Yes No _ X If yes, which official** and the nature of the item provided? Date Signature of ontr ctorlAppllcant _Chris Terry _ Print or type name of Contractor/Applicant * Person is identified as: any individual, firm, co -partnership, joint venture, association, social club, fraternal organization, corporation, estate, trust, receiver, syndicate, any other county, city, municipality, district, or other political subdivision, or any other group or combination acting as a unit. * official includes, but is not limited to: Mayor, Council member, Planning Commissioner, Member of a board, commission or committee of the City, and City employee or staff members, ** This disclosure Statement must be completed at the time the project application, or contract, is submitted to City staff for processing, and updated within one week prior to consideration by legislative body, Last Updated: March 16, 2010 row App. B 276 rourth Avenue I Chula Vista California RPv 217 91910 � {619} 691.51D1 s ^ t' D e v e l o p m e n t S e r v i c e s D e p a r t m e n t = Planning Division I Development Processing C.nv or (MULAVi`iA APPLICATION APPENDIX C Development Permit Processing Agreement Permit Application Conditional Use Permit Applicant Name Verizon Wireless, LLC co Brian Cook & Associates, Inc, Type of Permit - Agreement Date Deposit Amount This Agreement ("Agreement") between the City of Chula Vista, a chartered municipal corporation ("City") and the forenamed applicant for a development permit ("Applicant"), effective as of the Agreement Date set forth above, is made within reference to the following facts: Whereas, Applicant has applied to the City for a permit of the type aforereferenced ("Permit") which the City has required to be obtained as a condition to permitting Applicant to develop a parcel of property; and, Whereas, the City will incur expenses in order to process said permit through the various departments and before the various boards and commissions of the City ("Processing Services"); and, Whereas the purpose of this agreement is to reimburse the City for all expenses it will incur in connection with providing the Processing Services; Now, therefore, the parties do hereby agree, in exchange for the mutual promises herein contained, as follows: 1. Applicant's Duty to Pay. Applicant shall pay all of City's expenses incurred in providing Processing Services related to Applicant's Permit, including all of City's direct and overhead costs related thereto. This duty of Applicant shall be referred to herein as "Applicant's Duty to Pay." 1,1. Applicant's Deposit Duty. As partial performance of Applicant's Duty to Pay, Applicant shall deposit the amount aforereferenced ("Deposit"). 1.1.1. City shall charge its lawful expenses incurred in providing Processing Services against Applicant's Deposit. If, after the conclusion of processing Applicant's Permit, any portion of the Deposit remains, City shall return said balance to Applicant without interest thereon. If, during the processing of Applicant's Permit, the amount of the Deposit becomes exhausted, or is imminently likely to become exhausted in the opinion of the City, upon notice of same by City, Applicant shall forthwith provide such additional deposit as City shall calculate as reasonably necessary to continue Processing Services. The duty of Applicant to initially deposit and to supplement said deposit as herein required shall be known as "Applicant's Deposit Duty". 2. City's Duty. City shall, upon the condition that Applicant is no, in breach of Applicant's Duty to Pay or Applicant's Deposit Duty, use good faith to provide processing services in relation to Applicant's Permit application. 2.1. City shall have no liability hereunder to Applicant for the failure to process Applicant's Permit application, or for failure to process Applicant's Permit within the time requested by Applicant or estimated by City. Farm App. C E Rev 93.70 >- 276 Fourth Avenue � Chula Vista I California t 91910 { (619) 691.5101 P9 �/3 f D e v e I o m e n t S e r v 1 c e s D e p p a r t m e n t _ Planning Division I Development Processing AC rFY OF C"#-?fS��:�VISTA APPLICATION APPENDIX C - Page 2 Development Permit Processing Agreement 2.2. By execution of this agreement Applicant shall have no right to the Permit for which Applicant has applied, City shall use its discretlon in valuating Applicant's Permit Application without regard to Applicant's promise to pay for the Processing Services, or the execution of the Agreement. 3, Remedies. 3,1, Suspension of Processing In addition to all other rights and remedies which the City shall otherwise have at law or equity, the City has the right to suspend and/or withhold the processing of the Permit which is the subject matter of this Agreement, as well as the Permit which may be the subject matter of any other Permit which Applicant has before the City, 3.2, Civil Collection In addition to all other rights and remedies which the City shall otherwise have at law or equity, the -City has the right to collect all sums which are or may become due hereunder by civil action, and upon instituting litigation to collect same, the prevailing party shall be entitled to reasonable attorney's fees and costs, 4. Miscellaneous, 4.1 Notices. All notices, demands or requests provided for or permitted to be given pursuant to this Agreement must be in writing, All notices, demands and requests to be sent to any party shall be deemed to have been properly given or served if personally served or deposited in the United States mail, addressed to such party, postage prepaid, registered or certified, with return receipt requested at the addresses identified adjacent to the signatures of the parties represented, 4.2 Governing Law/Venue, This Agreement shall be governed by and construed in accordance with the laws of the State of California. Any action arising under or relating to this Agreement shall be brought only in the federal or state courts located in San Diego County, State of California, and if applicable, the City of Chula Vista, or as close thereto as possible. Venue for this Agreement, and performance hereunder, shall be the City of Chula Vista, 4.3. Multiple Signatories, If there are multiple signatories to this agreement on behalf of Applicant, each of such signatorles shall be jointly and severally liable for the performance of Applicant's duties herein set forth. 4.4. Signatory Authority. This signatory to this agreement hereby warrants and represents that he is the duly designated agent for the Applicant and has been duly authorized by the Applicant to execute this Agreement on behalf of the Applicant. Signatory shall be personally liable for Applicant's Duty to Pay and Applicant's Duty to Deposit in the event he has not been authorized to execute this Agreement by Applicant. 4,5 Hold Harmless, Applicant shall defend, indemnify and hold harmless the City, Its elected and appointed officers and employees, from and agalnst any claims, suits, actions or proceedings, judicial or administrative, for writs, orders, injunction or other relief, damages, liability, cost and expense (including without limitation attorneys' fees) arising out of City's actions in processing or issuing Applicant's Permit, or in exercising any discretion related thereto including but not limited to the giving of proper environmental review, the holding of public hearings, the extension of due process rights, except only for those claims, suits, actions or proceedings arising from the sole negligence or sole willful conduct of the City, its officers, or employees known to, but not objected to, by the Applicant, Applicant's indemnification shall include any and all costs, expenses, attorney's fees and liability incurred by the City, its officers, agents, or employees in defending against such claims, whether the same proceed to judgement or not, further, Applicant, at its own expense, shall, upon written request by the City, defend any such suit or action brought against the City, its officers, agents, or employees. Applicant's indemnification of City shall not be limited by any prior or subsequent declaration by the Al >276 Fourth Avenue Chula Vista California 91910 I (514) 591.5tp1 i f D e v e l o p m e n t S e r v i c e s D e p a r t m e n t '. Planning Division I Development Processing fmF�t.il t VIgVA APPLICATION APPENDIX C - Page 3 Development Permit Processing Agreement Applicant. At its sole discretion, the City may participate at its own expense in the defense of any such action, but such participation shall not relieve the applicant of any obligation imposed by this condition, 4.6 Administrative Claims Requirements and Procedures. No suit or arbitration shall be brought arising out of this agreement against the City unless a claim has first been presented in writing and filed with the City of Chula Vista and acted upon by the City of Chula Vista in accordance with the procedures set forth in Chapter 1,34 of the Chula Vista Municipal Code, as same May from time to time be amended, the provisions of which are incorporated by this reference as if fully set forth herein, and such policies and procedures used by the City in the implementation of same. Upon request by City, Consultant shall meet and confer In good faith with City for the purpose of resolving any dispute over the terms of this Agreement. Now therefore, the parties hereto, having read and understood the terms and conditions of this -agreement, do hereby express their consent to the terms hereof by setting their -hand hereto on the date set forth adjacent thereto, Dated:. By: (Staff) City of Chula Vista 276 Fourth Avenue Chula Vista, CA 91910 Lam` Dated: �. % l���.- By: .. (Applicant) Chris Terry Brian Cook & Associates, Inc. Form ARRC . Rev 03.10 276 Fourth Avenue J Chula Vista California 1 91910 1 (619) 691.5101 P�z�3 . PLANCOHr Telecommunications Project Management February 23, 2016 Mr. Harold Phelps CITY OF CHULA VISTA 276 Fourth Avenue Chula Vista, CA 91950 Re: Verizon Wireless — 580 Hilltop Drive — PCC -15-009 Response to Comments Dear Mr. Phelps, Enclosed for your review are revised drawings, coverage plots and a noise study for the Verizon Wireless site located at 580 Hilltop Drive. The drawings have been revised to address the issues identified in your incomplete letter dated March 10, 2015, in addition, we have prepared the following responses to each of the items identified in the letter: 1. The existing lights standard housing the Verizon Wireless communication facility is 31 feet in height. The proposed replacement monopine is 35 feet in height. The additional height is necessary to provide space for branches above the antennas to provide a more realistic appearance. The center height of the antennas will not increase in height, and in fact will be 1 foot lower on the monopine than on the light standard. 2. A noise study prepared by Helix Environmental Planning Inc. is included with this submittal package, 3. A coverage plot has been provided with this submittal package. The coverage plot shows the predicted coverage service area with the site as proposed and the coverage in the area without a site at this location. We believe we have addressed your issues. If you have any questions or need additional information, please contact me directly at (619) 208-4685. Sincerely, -. Nslhlly,lgned by 5he11yA Kllh-m Shelly A, KiIbourri nW:rn-ShelryR%IlGaurn,n,eu, email=shcllykElhau rnRcaKncl, c=US pale; 2016.02.23 gam:38 -08'0V Shelly A. Kilbourn, Land Use Planner Agent for Verizon Wireless Enclosures 302 State Place Escondido, CA 92029 699-208-4685 mobile 760-736-4993 fax A. Vejr#70 wireless Verizon wireless 15505 Sand Canyon Avenue Irvine, Ca. 92618 LETTER OF AUTHORIZATION (APPLICATION FOR ZONING/LAND USE ENTITLEMENTS) Property Address; 580 Hilltop Drive, Chula Vista, CA 91910 Vested Owner: Saint Marks Evangelical Lutheran Church - -- Assessor's Parcel Numbers; _ 569-281-02 Verizo(i site Name; North Chula iff Aa The undersigned, authorizes Verizon Wireless (VAW) LLC, a Delaware limited liability company, d/b/a Verizon Wireless, with its principal offices at 180 Washington Valley Road, Bedminster, New Jersey 07921, its employees, representatives, agents, and/or consultants, to act as agent on the undersigned's behalf for the sole purpose of obtaining land use approvals, building permits and or any other entitlements necessary for the purpose of constructing and operating a wireless telecommunications facility, including FAA filings, on the above identified parcel of land. It is understood that any application may be denied, r-sodified, or approved with conditions, and that such conditions or modifications rnust be complied with prior to issuance of building penviits. It heing further understood that signing this Letter of Authorization in no way creates an obligation of any kind. Vested Owner: Saint Marks Evangelical Lutheran Church 1 Print Name_ 'zi7i/IiL;`, Date:__