HomeMy WebLinkAboutAttach 9 Sec.1 ApplicationsIl¸
CITY OF DUBLIN PLANNING APPLICATION FORM
NOTE; Please discuss your proposal with Planning Staffprior to completing this form.
All items on this form related to your specific type of application must be completed..
Some of the items listed might not apply to your specific application. Please print or type
legibly. Attach additional sheets, if necessary.
TYPE OF APPLICATION:
Preapplication Review [Any type]
Conditional Use Permit [CUP]
Site Development Review [SDR]
Variance [VAR]
Tentative Subdivision Map [T MAP]
GENERAL DATA
××
Sign/Site Development Review [SIGN/SDR]
Master Sign Program [MSP/SDR]
Planned Development Rezone [PD REZ]
Rezone [REZ]
General/Specific Plan Amendment [GPA]
A. Address/Location of Property: ~ Corner West of Hacienda Drive, east of Arnold Road and north of Interstate 580
13. Assessor Parcel Number(s):_ 986-000~-040
C. Site Area: _27.54 acres_D. Zoning: _PD - Campus Offiee~E. General Plan Designation: Campus Office~
F. Existing/Proposed Use of Property: __See descriptions in attached Project Reference section of application nackae,
G Existing Uses of Surroundi.n.g Properties: __See attached Project Reference section of the application package
111.
Company:
Address:
Signature:
AUTHORIZATION OF PROPERTY OWNER AND APPLICANT
A. PROPERTY OWNER' In xlgnt'ng this applicatlon, /. as Property Owner, certi~ that ] have full legal capacity to, and
hereby do, aulhorize the fi/ing of thts applicatton. I understand that conditions of approval are binding. I agree to be
bound by' those conditions, subject only to the right to objecl al the hearings or during the appeal period l further certify
that the i~]brmation and exhibits submitted are true and correct.
(Note. ,4ll Property Owners must sign if property is jointly owned)
Name: _ _Patrick Cashmml Capacity: __Property Owner/Agent
Surplus Property Authority of Alameda County~Phone: (510) 670-6531
224 W. Winton Ave, Suite 110 Fax #: (510) 670-6,;374
Hayward, CA 94544
B APPLICANT (OTHER THAN PROPERTY OWNER).. In signing this application, 1, as Applicant, certify that I have
obtained written authorization from the property owner and have attached separate documentation showing my full legal
capacity to fi/e this application. I agree to be bound by the conditions of approval, subject only to the right to object at
the hearings or during lhe appeal period I further certify that the information and exhibits submitted are true and
coYrect.
Name: Dan Gustafsson, President
Company: ~
Address' _.~'~ /(est Germantown Pike
_Capacity: Property Owner/Agent _Purchaser/User
Phone: (610) 834-0180
Fax #: (610) 567-2~56
Date:
CITY OF DUBLIN
100 Civic Plaza, Dublin, California 94568 Website: http://www.cLdublin.ca.us
INITIAL STUDY
(ENVIRONMENTAL INFORMATION FORM - PART I)
(To be completed by Applicant pursuant to the City of Dublin
Environmental Guidelines Section 1.6)
Date Filed:
GENERAL INFORMATION:
Name and address of developer or project sponsor:
IKEA Property, Inc
496 West Germantown Pike Plymouth Meetine, PA 19462
Address of Project: Corner West of Hacienda Drive, east of Arnold Road and north of I- 580
Name, address and telephone number of person to be contacted concerning this project:
Mr. Dom, Greenholz
3350 Brunnell Drive
(510) 530-8630
Oakland~ California 94602
4. List and describe any other related permits and other public approvals required for this proj
those required by city, regional, state and federal agencies:
A Storm Water Dischar£e Permit from the RWQCB
5. Existing zoning dZstnct: PD - Campus Office
6. Description of PrOject: (Include site area, uses, size and number of buildings, parking, numb
dwelling units, scheduling, and any other ~nformation necessary or helpful to understand project. This attach.
description must be complete and accurate. Exhibits or photographs should be identified and attached.) -
7. Are the following items applicable to the project or its effects? Discuss below all items check
additional sheets as necessary).
YES NO
xx A. Change in existing features of any bays, tidelands, beaches, lakes or hills, or
substantial alteration of ground contours.
xx B.
Change in scenic views or vistas from existing residential areas or public
lands or roads.
xx C. Change in pattern scale or character of general area project.
x x D. Significant amounts of solid waste of litter.
Area Code (925). City Manager 833-6650. City Council 833-6650. Personnel 833-6605. Economic Development 833-6650
Finance 833-6640. Public Works/Engineering 833-6630. Parks & Community Services 833-6645. Police 833-6670
Planning/Code Enforcement 833-6610. Building Inspection 833-6620. Fire Prevention Bureau 833-6606
XX
xx
xx
xx
E. Change in dust, ash, smokel fumes or odors in vicinity.
F. Change in ocean, bay, lake, stream or ground water quality or quantity, or
alteration of existing drainage patterns.
G. Substantial change in existing noise or vibration levels in the vicinity
H. Site on filled land or on slope of 10 percent (10%) or more
1. Use of disposal of potentially hazardous materials, such as toxic substances,
flammables or explosives.
xx J.
Substantial change in demand for municipal services (police, fire, water, sewage,
etc.).
xx K.
xx L
ENVIRONMENTAL SETTINGS:
Substantial increase in fossil fuel consumption (electricity, oil, natural gas, etc.).
Relationship to a larger project or series of prOjects.
8. Briefly describe the project site as it exists before the project, including information on
topography, soil stability, plauts and animals, and any cultural, historical or scenic aspects. Describe any existing
structures on the site, and the use of the structures. If necessary, attach photographs of the site.
A description of the project site as it exists before the project is attached in the Project
eference section of the application materials.
9. Briefly describe the surrounding properties, including information on plants and animals, any
cultural, historical or scenic aspects and the type of land use.
A description of the surrounding properties is attached in the Project Reference section of
the application materials.
CERTIFICATION. I hereby certify that tile statements fitrnished above and in the attached exhibits present the
data and information required for this initial evaluation to the best of my abi[~B and that the facts, statements, and
information presented are true and correct to the best of my kno~J,~dg~e, jifiiff. '
Dated: ~g~7 ~.~ d"~o~
Prin~-Nan~
President
Title/Company
IKEA Property_, lnc