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521, Construct a new SFR and reloca, Application• Citt of JUL PROPERTY OWNER: OWNER'S ADDRESS: TELEPHONE NO: PROPERTY'S ADDRESS: REOUESTJOR HEARING CONDITIONAL USE PERMIT INCORPORATED JANUARY 24, 1937 NO 2 PORTuGuESE BEND ROAD ROLLING MILLS. CALIF 90274 (3i 0)377.1521 FAX. (310) 377.7288 Sekpooce-61Act6t 9,10 s DCp• 55 fI6 sApac,EAA0,16 p . LEGAL DESCRIPTION: LOT NO....._aD I ASSESSORS BOOK NO.751 PAGE oo,- PARCEL cz-- AGENT'S NAME: W A TE.e-- )4Et 1k, AGENT'S ADDRESS: SCCS R,, N. Ai aur° T 1 C.t1D. TELEPHONE NO: ((4) ( 44-6-' 7"0 el 9 NATURE OF PROPOSED PROJECT Describe in detail the nature of the proposed use and under what Section of the Zoning Ordinance the conditional use is permitted in the zone. We. A-A-F: P%PO S (M G, Lst f ,4fi..t s LION O 1°L M •1C l Z7i Al. 4) EX Ati.N3/0/11 r,P-S`'t-t Ya (17 '7'ff-A.4)0 r rl o 4 f- A r' vettT PR4Pri2X `f IS:S] !�=T f1niL • • Will the proposed use be compatible with the uses in the surrounding arca, and if so, whV.' rZ Av Q 1 5 cJ 4-2.-16UJJ D t P 1 L ..gEt? rafter . p e704.1=7 & ` 1-1 V,e tea r4• ' `Co n MI A•4•L USA r o(vsS -1 - - G tp 1-16vsr E r ,F /t 4 U. BAN ..t&L. k1 7EX c/ST(M6 Peertc:r 41.14 e iv ea An.' I= siA,2f,D n� -11 LS;Am S 7y'L - AS_ —rf fr1& N ,ti-erVA' F , Will the grant of this Conditional Use Permit be consistent with and in furtherance of the public health safety and general welfare? I dv11, G _ A- 4A car 5 Grp. p RirLL Y +Jc Na 1,4 fAer 1, -t It-{ WitWitA, 6 t D t::TFI,.1T zA,__ "7v Mei C. SA f ``t 7 FILING FEE A filling fee muat accompany the application. Make check payable to the CITY OF ROLLING HILLS. • ,SITE PLA;s1 REVIEW CRITERIA Site plan review criteria upon which the Planning Commission must make an affirmative finding. Describe in detail the project's conformance with the criteria below: A. Is the project compatible with the General Plan, the Zoning Ordinance and surrounding uses? Explain how it compares to the sizes, setbacks and other characteristics of neighboring houses. 1 PQei F .z✓"r f tAtS & em .12t7S26AiEb I.'i ci_d layrs t N6 e sr.( e,p�:f� a e„-rEA u(att„etr r .lp_trip - usg / s Fi'I.7 P, „ectt tQ P POPDf2-71'ce ' AIN) ev--r">~x..As r b-j dF 'lYE EX t S Ti -k sit E A r l p B. How does the project preserve and integrate into the site design, to the ntarintum extent feasible, existing nan:ral topographic features of the lot including surrounding native vegetation, manure trees, drainage courses, and knd forts (such as hillsides and knolls)? Explain how the project preserves and integrates existing natural features. F' '7 1-epos w 1-7 `r4 -ice e.x.t'- i t4G s K.49 P e g:NS p ( wrt-J - P.- iq ' '1- v NNd"t"� Gib L yk.S 1 'i Gv t c- 5 c ar rt,1 C04 .. 1Ail' Pc • C. How does the site development plan follow natural contours of the site to minimize grading? Extensive grading and recontouring of existing terrain to maximize buildable area shall not be approved. Graded slopes shall be rounded and contoured so as to blend with existing terrain. Grading shall not modify existing drainage redirect drainage flow unless into an exiting drainage course. Explain the nature and extent of the impact of grading and proposed minimization on lots. ero 2 =, tot reef. ult 1-4- c-L-am.) S T Ntc., c'9?v re ft-s Awe �3c�t✓ �'t• 7-t� ,&-' 0E0 A 17 1 .`1L S -i- 4 (- Pt t r4,t + f N IL' 4%_.&E EJ) tt-laNkei 7 . D. To what extent does the site development plan preserve surrounding nutit.e vegetation and supplement it tarir landscaping that is compatible with and enhances the taut character of the community? Landscaping shut.ld provide a buffer and transition zone between private and public areas. Explain how the project preserves native vegetation, integrates landscaping and cteatcb buffers. , u�,k121,--rt.✓r; vF � rza.rr �,.�_ rN� tom. b E Pp 'S � .4-.v olet� To 1G-f+ f- -N ce.- Co g.), --riu p i-re-cps /i, Tu., A rg S r—n ARQ No CI-416k-VegIP_ _tvLU 4r. tyowt` avtµtrt,l kiiU, -CT i'r-Arty R1.43E-C } N 7 N F V FP l- es • ;.F i•11-1iL • • E. How does the site development plan preserve time natural and undeveloped state of the lot by mininuang budding coverage? Lot coverage requirements shall be regarded as maximums and the actual amount of lot coverage permitted should depend upon the existing buildable area of the lot. Explain how the lot coverage proposed compares with lot coverage square footage and percentages on neighboring lots. THE EypA45t aN D E7 t EX t ri mstG Non_zt=1s biel6 OW FAN:, n ,,t' f-lo li4F Mitts P4IZ it-w_ela' .nF r/v Y4- tip nc t c'r (2!. ' j-10)41E. *$ L.eSs ca-p %-frt,ILN te 1-47-s w_e• 14-a-vF VA i rP ID . F. Is the site development plan harmonious in scale and mass with the site, the natural terrain and surrounding residences? Setbacks shall be regarded as minimums and more restrictive setbacks shall be imposed c%here necessary to assure proportionality and openness. Explain how the proposed project setbacks compare with the existing setbacks of neighboring properties. '71,�trr .�T�rvc� t-EoMz. l"S Ae-4,,tiVr /N111SlbL ��J .1r r WYz.- > lD `r41 mEa_ . A--- e 6 0 "tg4t_t Cpt5A e 0 f cr 15 Nor .tsi - ss nor_, G. is the site development plait sensitive and not detrimental to convenience and safety of circulation for pedestrians and vehicles? Explain how the number and types of vehicles relate to the driveway location, design, trip data, landscaping and other on -site parking or storage areas. 7+ .Q i2- u w j AN ID G _ngs S 17E /44645__ __ •7 C c( b Avo it Ave,-A4. -1156� op07 F Ja CON Uely N' _ H. Does the she development plan conform with the requirements of the California Environmental Quality Act? Explain how the project impacts the environment, c.g. significant impact, proposed mitigation measures. - I C r —vu r bar e4Ck " I7 54440 116 wo iy L : a I. • Ie.. a -NB, • / � N b P+4-t 4- } N`r 1'11i'r 5. 14146erw iX 6E. g-tr7 1Cs4Tn , •L= • I hereby certify that the statements furnished above, and in attached exhibits, presents the data and information required for the Site plan review criteria evaluation to the best of my ability; and, that the facts, statements and other information presented are true and correct to the best of my knowledge and belief, Date: 97/ Signature For: ie-A- / Jae (S C tom/ Applicant • r .Cn DATE l� • ZONING CASE NO. ADDRESS ii APPLICANT C4pl FL 1 CALCULATION OF Ill' WING; PAD COVERAG1 PAD NO. 1 BUILDABLE PAD ART_A RESIDENCE GAIZ.ACi E STABLE (BARN) POOL RECREATION COURT OTHER Cot) e-ST j4v S TOTAL STRUCTURES ON 1'AI) NO. 1 % BUILDING PAD COVERAGE .PAD NO. 2 BUILDABLE PAD Alth.A RESIDENCE GARACIE STABL1,' (BARN) POOL RECREATION C:OUR 1' OTHER TOTAL STRUCTURES ON PAD NO. BUILDING; 1'AD COVERAGE 2Qft. 4cQd 7 O 1- sq.ft. sq.ft. sq.ft. — sq.ft. 6 2 5- sq.ft. sq.ft. sq.ft. r sq.ft. _ sq.ft. (p410 sq.ft. sq.ft. sq.ft. r sq.ft. sq.ft. L 1 c/G oft_LeS.5 IIF.1 i1ri1L S • DATE 9/l 12- BUILDING AREAS NET LOT AREA BUILDING PAD(S) RESIDENCE GARAGE SWIMMING POOL/SPA STABLE RECREATION COURT � Ott AttAnct t r+cL • ) SERVICE YARD OTHER Guir s7 Ht3zS C ZONING CASE NO. ADDRESS C APPLICANT C'.4PI FAL.: CALL 'CATION Or LOT COVERAGE PROPOSED TOTAL ,a sq.ft. 70/1vL sq.ft. 4 3 sq.ft. 2 873 sq.ft. EXISTING 7c? I'z!j sq.ft. 61- sq.ft. z.1sq.ft. 70+ sq.ft. 400 sq.ft. 6410 sq.ft. r4 sq.ft. sq.ft. �` .21 sq.ft. G sq.ft. ,se sq.ft. 62.5. sq.ft. 6,2 sq.ft. sq.ft. '74? sq.ft, sq.ft. 70+ sq.ft. sq.ft. -- R(°17.(41;d:r1. sq.ft. 4240 sq.ft. sq.ft. sq.ft. -L4k TOTAL STRUCTURES 4/0 sq.ft. 2,71 q sq.ft. 732.cl sq.ft. % STRUCTURAL (poor % , -J . (o %D 10.4- % COVERAGE % TOTAL PAD COVERAGE 22. S. % DRIVEWAY 244�) sq.ft. PAVED WALKS AND PATIO AREAS `Z `1 sq.ft. (o �Lkr POOL DECKING / p, Q TOTAL FLATWORK 134 2.. sq.ft. % TOTAL FLATWORK COVERAGE I, 2, % TOTAL STRUCTURAL & FLATwORK COVERAGE /0'72. sq.ft. 67c TOTAL COVERAGE 25'.e % Cp 2- % 2.`?,'g' % or At war, 9AD. sq.ft. 24, sq.ft. Cn`i a sq.ft. /Casper, sq.ft. srocc, A-- t r) --- (.442. sq.ft. sq.ft. 54:6 sq.ft. 7 1 ?gyp sq.ft. % 32.Cp7sq.ft. 2I 5-1 sq.ft. C0'2 • '1 % •¢- % • • PROPERTY OWNER: OWNER'S ADDRESS: TELEPHONE NO: mi,anD SEP 2 01gg4 REOUEST FOR HEARING FOR SITE PLAN REVIEW A au( A 4to) 0(0--8388 CITY OF. ROLLING HILLS,. PROPERTY'S ADDRESS: SADDGGP..D b LEGAL DESCRIPTION: LOT NO. (p / ASSESSORS BOOK NO. 75Zel PAGE 095— PARCEL o© AGENT'S NAME: AGENT'S ADDRESS: TELEPHONE NO: 3 Ce5f Ai. lot s0612=(I LVt Any/Po YE�� Z CcCo3 l7(z3') (945=7a8� NATURE OF PROPOSED PROJECT Describe in detail the nature of the proposed project, including what aspects of the project require a Site Plan Review: SUIT iu47TFb PG>r:J�l M r2 ��' (T. P'L°AN U IEU- • DUE: -TO /,( ,A,00 / T7 G .A1 (IF )411` --- SVf r 7iN Z 7 j 6 ti t' t .. `-t f p, Qi°d D /J alC'C 74-nrit'r�.I 1J 7-O '7"H-F--- 125( 771tic-0, i F 13. Will any exterior walls be removed or relocated? Which walls? 14. Will any interior walls be removed or relocated? Which walls? 15. Will the entire building structure require a new roof? Yew . Date Filed • City 0/ R0f/ INCORPORATED JANUARY 24, 1957 ENVIRONMENTAL INFORMATION FORM (To Be Completed By Applicant) NO. 2 PORTUGUESE BEND ROAD ROLLING HILLS. CALIF. 90274 1310) 377.1521 FAX (310) 377.7288 Zoning Case No. lid% ��• 52/ GENERAL INFORMATION 1. Applicant C1VLSA-1-fir gietZ., G t-FAL; Address ' ' (pctwrC= Ez-cAo . goLL LL4fa f4fu-b A• 2. Legal Owner & cik f2-c Ply-y�L( Address e(S1C) 3oCa-£ 3 8$ Tel.4lO) 3Ca-83-88 3. Project Address I1-c?_ <S4o,0 e,,ACL - D . Assessor's Book, Page, Parcel No. 1$62-p - (9OS - C510 2. Lot No. G l 4. List and describe any other related permits and other public approvals required for this project,inciuding those required by city, regional, state and federal agencies: S CePo'-rro1-14-e— ()FE- P cT &/1L4)rr4CQ tiT , 5. Existing zoning district 2,A - S — I 6. Proposed project/use of site: '5 11c\(.r n L E r7A-0tt PROJECT DESCRIPTION 7. Site size 8. Net lot area 9. Total square footage of structures toea-ET:) 7 2 7 p-r ers ton to -rim— • 10. Number of floors of construction D N 11. Basement square footage 12. Total combined flatwork and structural lot coverage jY Ery S T} '35---9 ppooloo rce . /J6 f2-734 w r., P t4- sue' /.F-E06ri.5G 7b ti • • 16. Will the existing roof remain intact, with less than 200 square feet added? No . 17. Will cut and fill be balanced? Amount cut I 0 C4 . • Amount fill d 18. Area of disturbance. Square feet (7Co'27 . Percentage of net lot 9. � c 19. If residential, include the unit size, approximate sale price and household size expected. 20. If commercial, indicate the type of project, whether neighborhood, city or regionally oriented, square footage of sales area, estimated employment per shift and loading facilities. 21. If this is industrial project indicate the type of project, estimated employment per shift, and loading facilities. j.1/At 22. If institutional, indicate the major function, estimated employment per shift, estimated occupancy, loading facilities, and community benefits to be derived from the project. N/A. 23. Attach plans. 24. Proposed scheduling. 25. If the project involves a variance, conditional use or rezoning application, state this and indicate clearly why the application is required. %fit- collvcm A-)A4._, tJS P64214.iT is `lz-Q?u(t?P F -T pn..®-Po-sEt) uEsr terse. Are the following items applicable to the project or its effects? Discuss below all items checked yes (attach additional sheets as necessary). YES NO V. 26. Change in existing features of any bays, tidelands, beaches, lakes or hills, or substantial alteration of ground contours. 27. Change in scenic views or vistas from existing residential areas or public lands or roads. 28. Change in pattern, scale or character of general area of project. V� 29. Significant amounts of solid waste or litter. 1/ 30. Change in dust, ash, smoke, fumes, or odors in vicinity. 1/ 31. Change in ocean, bay, lake, stream or ground water quality or quantity, or alteration of existing draining patterns. Z. 32. Substantial change in existing noise or vibration levels in the vicinity. 33. Site on filled land or on slope of 10 percent or more. —2— 1MS. E4 29. Significant amounts of solid waste or litter. 30. Change in dust, ash, smoke, fumes, or odors in vicinity. 31. Change in ocean, bay, lake, stream or ground water quality or quantity, or alteration of existing draining patterns. 32. Substantial change in existing noise or vibration levels in the vicinity. 33. Site on filled land or on slope of 10 percent or more. 34. Use or disposal of potentially hazardous materials, such as toxic substances, flammable or explosives. 35. Substantial change in demand for municipal services (police, fire, water, sewage, etc.). 36. Substantially increased fossil fuel consumption (electricity, oil, natural gas, etc.). 37. Relationship to a larger project or series of projects. ENVIRONMENTAL SETTIN( 38. Describe the project site as it exists before the project, including information on topography, soil stability, plants and animals, and any cultural, historical or scenic aspects. Describe any existing structures on the site, and the use of the structures. Attach photographs of the site. Snapshots or polaroid photos will be accepted. ThF tt.0 TT tJtp FAD A/A-S C' jPig-0`J`t-c-% IN Ct e4A- /9 6 iJ +0 � - ! i t S C AD LY o/vepr ---izv }- 6 Awe( fd- inx, , - o vs r c .P -ta t - 4y G L ,4 Da S-f -t4cnr - S•; LV i -m . ' fla%fd121a4 k r G t iC ) 41-4 02 wvsta-co%) . 39. Describe the surrounding properties, including information on plants and animals and any cultural, historical or scenic aspects. Indicate the type of land use (residential, commercial, etc.), intensity of land use (one -family, guest house, office use, etc.) and scale of development (height, frontage, set -back, rear yard, etc.). Attach photographs of the vicinity. Snapshots or polaroid photos will be accepted. et/tet /'c/ U C JAsktAGg. (iv 07x.rrawy- ti s f 61,6 ,4a4-0 ° ) Ads'-1 ` s7" 6 lter4 c (1Ntu� r S V N 2 — 12-4A ADO .1a-r 15 t-L ,/2O se( r-e ,. /./v tic*- -,.- c<..J i --T �'E !i-cIoF' / S it` Pga-Kci Ancrt. f/ i' F40 -r no$ucol —r-H s' LoT C PActe--re c- APRe4-Be sc-Te - v e r Gc--iiU. P 0 R--s.3- • ENVIRONMENTAL IMPACTS (Please explain all "yes" and 'maybe" answers on separate sheets.) 40. Earth. Will the proposal result in: a. Unstable earth conditions or in changes in geologic substructures? b. Disruptions, displacements, compaction or overcovering of the soil? c. Change in topography or ground surface relief features? d. The destruction, covering or modification of any unique geologic or physical features? e. Any increase in wind or water erosion of soils, either on or off the site? f. Changes in deposition or erosion of beach sands, or changes in siltation, deposition or erosion which may modify the channel of a river or stream or the bed of the ocean or any bay, inlet or lake? g• Exposure of people or property to geologic hazards such as earthquakes, landslides, mud slides, ground failure, or similar hazards? 41. Air. Will the proposal result in: a. Substantial air emissions or deterioration of ambient air quality? b. The creation of objectionable odors? c. Alteration of air movement, moisture or temperature, or any change in climate, either locally or regionally? 42. Water. Will the proposal result in: a. Changes in currents, or the course or direction of water movements, in either marine or fresh waters? b. Changes in absorption rates, drainage patterns, or the rate and amount of surface water runoff? c. Alterations to the course or flow of flood waters? d. Change in the amount of surface water in any water body? e. Discharge into surface waters, or in any alteration of surface water quality, including but not limited to temperature, dissolved oxygen or turbidity? Mi MAYBE _ND z V Jr -4- f. Alteration of the direction or rate of flow of ground waters? g• Change in the quantity of ground waters, either through direct additions or withdrawals, or through interception of an aquifer by cuts or excavations? yX MAYBE ZIQ h. Substantial reduction in the amount of water otherwise available for public water supplies? i. Exposure of people or property to water -related hazards such as flooding or tidal waves? Significant changes in the temperature, flow, or chemical content of surface thermal springs? 43. Plant Life. Will the proposal result in: a. Change in the diversity of species, or number of any species of plants (including tress, shrubs, grass, crops, microflora and aquatic plants)? b. Reduction of the numbers of any unique, rare or endangered species of plants? c. Introduction of new species of plants into an area, or in a barrier to the normal replenishment of existing species? d. Reduction in acreage of any agricultural crop? 44. Animal Life. Will the proposal result in: a. Change in the diversity of species, or numbers of any species or numbers of any species of animals (birds, land animals including reptiles, fish and shellfish, benthic organisms, insects or microfauna)? b. Reduction of the numbers of any unique, rare or endangered species of animals? c. Introduction of new species of animals into an area, or result in a barrier to the migration or movement of animals') d. Deterioration to existing fish or wildlife habitat? 45. Noise. Will the proposal result in: a. Increases in existing noise levels? 1/- V b. Exposure of people to severe noise levels? 46. Light and Glare,. Will the proposal produce new light or glare? 47. Land Use. Will the proposal result in a substantial alteration of the present or planned land use of an area? 1/ -5- • 48. Natural Re5ourcc4. Will the proposal result in: a. Increase in the rate of use of any natural resources? b. Substantial depletion of any nonrenewable natural resource? 49. Risk of Ur. Will the proposal involve: a. A risk of an explosion or the release of hazardous substances (including, but not limited to, oil, pesticides, chemical or radiation) in the event of an accident or upset conditions? b. Possible interference with an emergency response plan or an emergency evacuation plan? 50. Population. Will the proposal alter the location, distribution, density, or growth rate of the human population of an area? 51. Housing. Will the proposal affect existing housing, or create a demand for additional housing? 52. Transportation/Circulation. Will the proposal result in: a. Generation of substantial additional vehicular movement? b. Effects on existing parking facilities, or demand for new parking? c. Substantial impact upon existing transportation systems? d. Alterations to present patterns of circulation or movement of people and/or goods? e. Alterations to waterborne, rail or air traffic? f. Increase in traffic hazards to motor vehicles? 53. Public Services. Will the proposal have an effect upon, or result in a need for new or altered governmental services in any of the following areas: a. Fire protection? b. Police protection? c. Schools? d. Parks or other recreational facilities? e. Maintenance of public facilities, including roads? f. Other governmental services? YES MAYBE EQ V -6- 54. Energy. Will the proposal result in: a. Use of substantial amounts of fuel or energy? b. Substantial increase in demand upon existing sources of energy, or require the development of new sources of energy? 55. Utilities. Will the proposal result in a need for new systems, or substantial alterations to the following utilities: a. Power or natural gas? b. Communications systems? c. Water? d. Sewer or septic tanks? e. Storm water drainage? f. Solid waste and disposal? 56. Human Health. Will the proposal result in: a. Creation of any health hazard or potential health hazard excluding mental health? b. Exposure of people to potential health hazards? 57. Aesthetics. Will the proposal result in the obstruction of any scenic vista or view open to the public, or will the proposal result in the creation of an aesthetically offensive site open to public view? 58. Recreation. Will the proposal result in an impact upon the quality or quantity of existing recreational opportunities? 59. Cultural Resources. a. Will the proposal result in the alteration of or the destruction of a prehistoric or historic archeological site? b. Will the proposal result in adverse physical or aesthetic effects to a prehistoric or historic building, structure, or object? c. Does the proposal have the potential to cause a physical change which would affect unique ethnic cultural values? d. Will the proposal restrict existing religious or sacred uses within the potential impact area? MAYBE Lv4 V V v t� -7- • • 60. Mandatory Findinz of Significance. YES MAYBE lip a. Does the project have the potential to degrade the quality of the environment, substantially reduce the habitat of a fish or wildlife species, cause a fish or wildlife population to drop below self-sustaining levels, threaten to eliminate a plant or animal community, reduce the number or restrict the range of a rare or endangered plant or animal or eliminate important examples of the major periods of California history or prehistory? b. Does the project have the potential to achieve short-term, to the disadvantage of long-term, environmental goals? (A short- term impact on the environment is one which occurs in a relatively brief, definitive period of time while long-term impacts will endure well into the future) c. Does the project have impacts which are individually limited, but cumulatively considerable? (A project may affect two or more separate resources where the impact is relatively small, but where the effect of the total of those impacts on the environment is significant) d. Does the project have environmental effects which will cause substantial adverse effect on human beings, either directly or indirectly? -8- NOTE: Before the Lead Agency can accept this application as complete, the applicant must consult the lists prepared pursuant to Section 65962.5 of the Government Code and submit a signed statement indicating whether the project and any alternatives are located on a site which is included on any such list, and shall specify any list. HAZARDOUS WASTE AND SUBSTANCES STATEMENT The development project and any alternatives proposed in this application are contained on the lists compiled pursuant to Section 65962.5 of the Government Code. Accordingly, the project applicant is required to submit a signed statement which contains the following information: 1. Name of applicant: i'f1- fk. . (l4)( 41-( 2. Address: 3. Phone Number: ( 1 � C 8388 4. Address of Site (street name and number if available, and ZIP code): (1-d'Gu t4l.? (kC L . 0-4 - 5. Local Agency (city/county): 12 00.F 44614{.I L LYS' AN-6F5- r 6. Assessor's book, page, and parcel number: 75Za-c7 CC)5 co 7. Specify any list pursuant to Section 659625 of the Government Code: STATE OF CALIFORNIA HAZARDOUS WASTE AND SUBSTANCES SITES LIST (available at City Hall). 8. Regulatory identification number: 9. Date of List: JULY 1992 Date qltslv;- Signature For (' f°(L� Applicant -9- NOTE: In the event that the project site and any alternatives are not listed on any list compiled pursuant to Section 659625 of the Government Code, then the applicant must certify that fact as provided below. - - I have consulted the lists compiled pursuant to Section 659625 of the Government Code and hereby certify that the development project and any alternatives proposed in this application are n= contained on these lists. Date 6111 /62 1I Signature For Applicant CERTIFICATION: I hereby certify that the statements furnished above and in the attached exhibits present the data and information required for this initial evaluation to the best of my ability, and that the facts, statements, and information presented are true and correct to the best of my knowledge and belief. Date For forms\environm.app Signature Applicant -10- COUNTY OF LOS ANGELES ACCESS CERTIFICATE FOR BUILDING PERMIT ONE AND TWO FAMILY DWELLINGS (R-3) PRIVATE ALL-WEATHER ACCESS ROAD ONLY PART I - INFORMATION SHEET BUILDING ADDRESS • L.A. COUNTY FIRE DEPARTMENT Fire Prevention Bureau Fire Protection Engineering 5823 Rickenbacker Road Commerce, CA 90040 (213) 720-5141 CITY OR AREA Pe(.1.-(, k6, 4kLLS NEAREST CROSS STREET '6 9 .-(fk1v DISThNCE TO NEAREST CROSS STREET MAIL PROPERTY OWNER el)(-V,GA-19(rAG ADDRESS £K/.d,( S,A TEL, / 0) ,5 f3,i ae) DESCRIPTION OF BUILDING � [ Le-!�{ ec1941->ce • PRESENT /LO)fl � / » iT [' - I SIGNATURE 0 * * * * * * * * * * * * * * * * * * * * * PART II ACCESS STANDARDS CERTIFICATION: { c,5 <C I hereby certify that the c� cess road serving the apparatus'and is consistent with the standards as Fire Code Standard No. 10.207. Name Telephone Address q://6)q bATE Complies with Section 10.207 of the Fire Code above property will support Fire set forth in County of Los Angeles Stamp Signature of Engineer Date ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * PART III - ACCESS IMPROVEMENTS REQUIRED: Improvements required to provide compliance with Section 10.207 of the Fire Code. I hereby certify that upon completion of the improvements indicated on the attached plans, the access road serving the above. property will comply with the standards set forth in County of Los Angeles Fire Code Standard 10.207. Name Telephone Address Stamp Signature of Engineer Date This approval valid for six (6) months. Renewable upon resubmission of current data. * * OWNER'S DECLARATION I (We) declare under penalty of perjury that the foregoing is true and correct. Executed at c\lia-Ci 4- \\ this I l n day of By: By: ptern\2ek, ram--t12.�f lU / U 4Qd d le bad \d Address Ll! rk 112)11S, C4 . g0a.14_. , California, , 19 14 NOTE: The Owner's Declaration can only be used if this application is signed in California. If this application is signed outside of California, the applicant should acknowledge before a Notary Public of the State where the signature is fixed, or before another officer of that State authorized by its laws to take acknowledgements, that he (it) owns the property described herein, and that the information accompanying this application is true to the best of his (its) knowledge and belief. Attach appropriate acknowledgment here. APPLICANT: t _ . - ikS • CAP i V A V REPRESENTATIVE: W (�, Nk COMPANY NAME: O-s N UP - COMPANY ADDRESS: s B. A). /JEivPa/T LC -Ur) , NSrv6'dAr 8 , CA 92Z(3 COMPANY PHONE NO. f 744161-6-7o67 PROJECT ADDRESS: 47 sope. 6C. DATE FILED 9//z 441 FEE: 3Z RECEIPT NO: C787 BY: patta ZONING CASE NO: 5Z/ TENTATIVE HEARING DATE: OWNER'S ACKNOWLEDGEMENT Property development in Rolling Hills is governed by ordinances of the CITY OF ROLLING HILLS ("City") and by private deed restrictions enforced by the ROLLING HILLS COMMUNITY ASSOCIATION ("RHCA"). The land development permit process of the City and the RHCA are completely independent and separate. Both must be satisfied and approval given by both the City and the RHCA to develop property in Rolling Hills. An approval by either the City or the RHCA does not mean or imply or ensure approval by the other. The suggested sequence of property development is to obtain City approvals first. I, (We), the undersigned, acknowledge that the above statement has been fully read and its admonition is completely understood. Executed at this c,aG -I-i ► Its day of ,tepiem bed, By: \`‘'" rQ l9 , California n , 196fri- I By: a.l Address e.ogiri G -� 11 cfoa-zzl City