HomeMy WebLinkAboutItem 2 - Attch 4 - Disclosure LetterMy OF
CHULA VISTA
Type of Review Requested
❑ Conditional Use Permit
XDesIgn
❑Varia
Review
❑ 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
Applicant Name G J FR' (AN %/V V6Sr1W 6/111'5
Applicant Address 1041. -7-I4T�RA per. gq 0,0
Contact. -Name
Applicant's Interest In Property (If applicant is notthnkowner, the owner's authorization signature at the end of this form is required
to process this request,) Own Rent ❑ Other
Architect/Agent nm Address go/v/ ?-A ap3oJ /I/f J94'L
Contact Name Phone
Primary Contact is: ❑ Applicant Architect/Agent E-mail of primary contact IMT
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.d .ca, oo iteClean up/Co rtes e_List,cfm. The development project and any alternatives proposed in this application
( ) is ( is no ontained on the lists compiled pursuant to Section 65962.5 of the Government Code,
If Yes, provi ulatory Identification Number: Date of List:
Historical Resources
The year(s) all structures were constructed on the property
If property is designated historical, provide Site # NO
I certify that the information above is correct and accurate to the best of my knowledge. 1 un ers%i ha�thepro�jectWlll be
reviewed based on the information provided )
Print Name / 11.*7 P '`mA,:rs Signature r Date _167110-
General Project Description (all types)
Project Name / /VL5 "--ff' pro o ed Use
Project Description ._ Z-UNa ��ld,/fL� r&
Has this project received pre -application review comments? ❑ Yes (Date)
Subject Propert
Information (all types)
Location Street Address 41/Y-3 4
Parcel # .5'/6 Total Acreage
General Plan Designation Zone Classification
Planned Community (If aplicabie) -_ ®
Redevelopment Area (if applicable) N
Current Land Use _R -3
276 Fourth Avenue I Chula Vista I California ! 91910 1 (619) 691.5101
0
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 l Development Processing
CITY OF
CHU[AVISTA APPLICATION Type A Part 2
Type of use proposedsidential ¢ EJ Commercial El Industrial / 71 Mixed Use
Landscape Coverage (off of lot), `�_� _ Building Coverage (% of lot) !a
Residential Project Summary
Type of dwelling unit(s) -3 Number of lots
Dwelling Units PROPOSED EXISTING
1 Bedroom
2 Bedroom
3+ Bedroom
TOTAL
J
Density (DU/acre) Maximum building height Minimum lot size �' Average lot size --
Parking Spaces
Required Provided
Type of parking (i,e, size; covered, etc.) 6"'Aa�. 4—c'4�eWT-
Open
Space description (acres each private, common, and landscaping) t0-714
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
Print applicant name
Applicant Signature
Print owner name*
Owner Signature*
Existing
Building Height
Maximum number of employees at any one time
Seating capacity
[late / /91.5
Date
* Note: Proof of ownership may be required. Letter of consent may be provided In lieu of signature.
Form320
Nev 04.10
276 Fourth Avenue I Chula Vista I California 1 91910 1 (619) 691.5101 Pg2�
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 } Development Processing
CITY OF
CHU[A VISA
APPLICATION APPENDIX A
Project Description & Justification
Project Name
Applicant fume C/ 1,41V
Please fully describe the proposed project, any and all construction that may be accomplished as a result of approval of
this project, and the project's benefits to yourself, the property, the neighborhood, and the City of Chula Vista. include
any details n-ece-ssary toa-dequate iy explain the scope and/or operation of the proposed project. You may include any
background -Information -and supporting statements regarding the reasons for, or appropriaten-ess 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.
-00 7- ®I ' � / D a W45�?16e911116 Ade-!/rvvo
1 (519) 641.5101 Form
275 Fourth Avenue Chula Vista California 919113 Rev310
«l� D e v e l o p m e n t S e r v 1 c e s D e p a r t m. e n t
Planning Division I Development Processing
CITY OF
CHUTAVISTA 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).
I cK C /eiel
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.
f n I G%4 *✓ %>�N
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.
5. Has any person *identified in 1„ 2., 3., or 4„ above, or otherwise associated with this contract, pro'ect
or application, had any financial dealings with an official** of the City of Chula Vista as it rel to to this
contract, project or application within the past 12 months? Yes No
A
if yes, briefly describe the nature of the financial interest the official** may have in this contract.
!�
' re�
App. B
Rev03,lo
276 Fourth Avenue I Chula Vista California 1 91910 (619) 691.5101 Pg1�2
a
M of
CHUiA VIVA
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
Planning Division I Development Processing
Disclosure Statement - Page 2
APPLICATION APPENDIX 8
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) montht�a
current member of the City of Chula Vista Council ? Yes No
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 priceo ything of value, money to retire a legal debt, gift, loan,
etc.) . Yes No
If yes, which official** .and what was the nature of -the-item providedT
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
If yes, which official** and the nature of thXtern provided?
Date 411)15-
Signature
of Contra
Print or type name of Contractor/Applicant
# Person is identified as; any individual, firm, co -partnership, jolntventure, 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.
* officlal 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
Form
App. B
Hev 03.50
276 Fourth Avenue I Chula Vista I California 1 91910 1 (619) 691.5101 rg>�
D e v e I o p rn e n t S e r v 1 c e s D e p a r t m e n t
z�4 Planning Division Development Processing
CITY OF
CHUI.AVISTA APPLICATION APPENDIX C
Development Permit Processing Agreement
Permit Application
Applicant Name
Type of Permit
Agreement Date
Deposit Amount
P OVl{I6S
StPN Trr�Vl�
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").
1.1.9. 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 frame requested by Applicant or estimated by City.
IN
€ >
276 Fourth Avenue I Chula Vista i California 1 91910 1 (619) 691.5101
�� 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
CITY OF
CHU[AVISfA 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 discretion 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 othetw€se 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 shail 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 property 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 signatories 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 duty 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 mold Harmless.
Applicant shall defend, indemnify and hold harmless the City, its elected and appointed officers and
employees, from and against any claims, suits, actions or proceedings, judicial or administrative, for writs, orders,
injunction or other relief, damages, liability, cost and expense (including without lim€cation 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
Farm
App, C
276 Fourth Avenue Chula Vista California 91910 1 (619) 691.5101 Revaa,�o
Pg 213
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
CHY OF
CHULA VISTA
Development Permit Processing Agreement
APPLICATION APPENDIX C - Page 3
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:
Dated: 11I lk By:
(Staff)
City of Chula Vista
276 Fourth Avenue
Chula Vista, CA 91910
/ 1 ✓ rr �% %- rs I i Uvr •-n 4�
' ys 6W17W I'D 90.5a -I
Aory.774 C- It 901-
�o�m
hpp. C
Rev 03.10
276 f=ourth Avenue I Chula Vista I California 1 91910 1 (619) 691.5101 ryzi�