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726, Extension of previously approv, Application03/31/200$ 14:05 310-544-040 BOLTON ENGINEERING A PAGE 01 City O f F Ri in JVtt i +I INcO PORAT D JANUARY 14, 19.57 '4BJANCE REOL' ►tTEOR 11EA,RINcit NOTE: According to Section 17.24.020 of the Railing Hills Municipal Code, Illegal uses or structures are required to be made conforming or shall be removed, Therefore, you may be required to rodlfy Or remove any unouthorised or unlawful use or structures on your property prior to or in co►yunctAon with this application, In addition,pursuant to Resolution No. 900 of the City Council, any use or structure which would require a di;rcretionary permit but which is conducted without the acquisition of said permit, shall be subject t'o remxtcttve discretionary permit privity, and is subject to higher application,. PROPERTY OWNER: CeD , n C t) E OWNERS ADDRESS: 2,CoL,T i O , \,), C , , TELEPHONE NO.: (((;) P)- 7 i 2 Q PROPERTY ADDRESS: LEGAL DESCRIPTION: LOT NO. 2 9 • ASSESSOR'S EIOOK NO. '72. PAGE .n 0 .3 PARCEL AGENT'S NAME: AGENTS ADDRESS: TELEPHONE NO.: MO. 2 POFT410LIES2 1tE110 ROAD A011.'Rt0 HILLS, CALIF. 90274 (31013774921 FAX: (3101377.72EI1 fs ms L cttytitr ent.i:em c: + ) � s ram rwl c 7 c ""� ` , i �� tie ' 4"4 l (�,- , _ Ca. `? Q '�`1, (7)1r1 (co>c Describe in detail the nature of the proposed use, including what aspects of the project require a Variance, r") i A ri r�t t�� � �r 42. o r`l (-► R'a ) ( C iC Z0 3Jdd armrest C A*cSor,nd r,4 onvovw BEI ILLO9L 60:TZ 900Z/L0/50 03/31/2006 14:06 310-544-0451111 BOLTON ENGINEERING i PAGE 02 Gria_to be satisfied -for grant of Vjiti Such change is based upon the following described exceptional or extraordinary circumstances condition that do not apply generally to other property in the same vicinity and zone. 11/4 i \ '', %i•1 t _. ey t:.l L.•. `1) L. of c:. i 1 < 0 ) To /.\ "-,- ...... •l1 c:, 7....61, 3 tt. Vt) /7.) 1. > t.,.. ( or Such change will not be materially detrimental to the public welfare nor injurious to the property or improvements in such vicinity and zone where property is locatctl because l i 'NA,) • j-i (..; N („n MLIYInOr FILING FEE A filing fee must accompany the application. Maim check payable to: cirri, OF ROLLING RILLS, ZO 39dd Qmd9dw SETtILL09L 60:TZ 900Z/L0/90 DATE'? - ? _ 0 (c, ZONING CASE NO. ADDRESS 7 0 0 1 Z t 0 G' ALL STRUCTURES MUST BE SHOWN ON THE PLAN CAUULATION OF LOT covERAgg AREA AND STRUCTURES NET LOT AREA RESIDENCE GARAGE SWIMMING POOL/SPA POOL EQUIPMENT GUEST HOUSE CABANA STABLE (dirt volume to be included in grading quantities) RECREATION COURT ATTACHED COVERED PORCHES ENTRYWAY/ PORTE COCHERE. BREF7RWAYS ATTACHED TRELLISES *DETACHED STRUCTURES: (circle all that applies) SHEDS. TRELLISES. OAZEI3O, BARBECUE, OUTDOOR KITCHEN, ROOFED PLAY EQUP.- over 15 ft. high and over 120 sq. ft. in area, WATER FEATURES, ETC. SERVICE YARD OTHER BASEMENT AREA _ (volume to be included in grading quantities) DEPTII OF BASEMENT ,EXISTING '37.3 Z 0 sq.ft. �t 'l E1 3 sq.ft. 4 C► sq.ft. esq.ft, e sq.ft. sq.ft. sq.ft. _ sq.ft. sq.ft. (q sq.ft. . 4 E' sq.ft. TOTAL STRUCTURES % STRUCTURAL COVERAGE TOTAL STRUCTURES EXCLUDING UP TO 5 & UP TO 600 sq. ft. detached structures that are not higher than 10 ft. % STRUCTURAL COVERAGE sq.ft_ sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. 6 '34 sq.ft. 1 1,cJ % sq.ft. PROPOSED sq.ft. sq.ft. sq.ft. sqM, sq.ft. sq.ft. sq.ft. 1 2 sq.ft. sq.ft. TOTAL 37132.0 G�+f3?) 540 7 3g ()lk. sq.ft. sq.ft. sq.ft, sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. l sq.ft. sq.ft. t 46 sq.ft. sq.ft. sq.ft, sq.ft, sq.ft. sq.ft. sq.ft. sq.ft. sq.ft, sq.ft. G 1 2., sq.ft. 2, 4 % sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft, 7 - 46 sq.ft. % sq.ft. 9'0 60 3Jdd apndodw 8EtbtLL09L 60:tZ 900Z/L0/90 • • ALL FLATWORK MUST BE SHOWN ON THE PLAN PRIMARY DRIVEWAY(S) PAVED WALKS, PATIO AREAS, COURTYARDS POOL DECKING 3 5 7 sq.ft. sq.ft. 3 2 7 sq.ft. t. 248 t . sq.ft. sq.ft. 2_4-7 sq.ft. sq.ft. Z 8 ( sq.ft. 2476 sq.ft. OTHER PAVED DRIVEWAYS, ROAD EASEMENTS. PARKING PADS ` _" sq.ft- sq-ft- --- . ..... sq. ft. TOTAL FLATWORK 2.e Co sq.ft. sq.ft. 6 Z S sq.ft. % TOTAL FLATWORK COVERAGE ((o, e) % 9h 147,6 % TOTAL STRUCTURAL & FLATWORK COVERAGE % TOTAL COVERAGE TOTAL STRUCTURAL & FLA,TWORK COVERAGE Excl. the allowance of up to 5 — 6Q0 sq. ft. structures from previous page. 2. ban sq.ft. sq.ft. t ,h 3 2 sq.ft. 1 % Y % sq.ft• sq.ft. — sq.ft. I, TOTAL COVERAGE TOTAL DISTURBED AREA % DISTURBED AREA GRADING QU,ANTIT'Y (include future stable, corral and access way; basement and all other areas to be graded) • ! t 4 7 (II_ scf.ft. sq.ft. (ti 1 ti Ft) sq.ft. 4-.1 % 42-..1_ % 69 cubic yards All structures (attached and detached) must be listed, * Free standing accessory structures such as sheds, trellises, covered patios, g bo, fountains, bat cue, outdoor fire place, etc., are not counted towards coverages and disturbed area, unless their combined area exceeds 600 sq. ft., or if there are more than 5 such structures on the property. Mastcronri,*ariarrco- Rcv.2006 170 30Vd a9ndSdw BEtIILL09L 60:tZ 900Z/L0/90 DATE - 0 <a Z. C. NO. ADDRESS 7 00 r i2_t t c ,CULATION OEBUILDING PAD CO'V PSAGE rAp NO, BUILDABLE PAD AREA EXISTING PROPOSED TOTAL AND STRUCTURES BUILDING PAD t9,5 q2sq ft sq_ft. RESIDENCE 4-4 5 3sq. ft. sq.ft. GARAGE 540 sq,ft. sq.ft. POOL/SPA 7 ,q.ft. sq.ft. POOL EQUIPMENT S 4 sq.ft, sq.ft. CABANA/REC112 sq.ft. sq.ft. GUEST HOUSE sq.ft. sq.ft. STABLE sq.ft. 912. Sq.ft. SPORTS COURT _ sq.ft. sq.ft. SERVICE YARD (o sq,ft. sq,ft. ATTACHED COVERED PORCHES I �,� Primary residence sq.ft. Accessory structures sq.ft. AREA OF ATTACHED COVERED PORCHES THAT EXCEED io% OF THE SIZE OF RESIDENCE/ACCS. STRUCTURE s 19, 5 8 sq_ft. 4483 sq.ft, '5 4'0 <q.ft. e sq.ft. e sq.ft. sq.ft. �7 (2 aq.ft. sq.ft. sq.ft. sq.ft- <q.ft. sq.ft. sq.ft. sq.ft. sq.ft. ENTRYWAY/PORTE COCHERE/ BREEZEWAY l A' S 8q.ft. sq.ft. 14' _,sq ft ATTACHED TRELLISES sq.ft. sq.ft. sq.ft. ALL DETACHED STRUCTURES sq,ft_ sq.ft. sq.ft, (from P page) ALL DETACHED Si"I&UCTURES sq.ft, sq.ft. sq_ft. (from 1'` page not including allowed deductions) OTHER sq.ft. sq.ft. sq.ft. TOTAL STRUCTURES ON PAD NO. 1(a 3 34 sq ft. 4 l '- sq.ft. 7"24 b sq.ft. % BUILDING PAD COVERAGE . .32. 4 96 % 37. 046 TOTAL STRUCTURES ON PAD NO. 1 eiC/ I sq.ft. sq.ft. to ,�' sq.ft. /0 •1 Not incl, attached trellises, Not. incl. allowed deductions, and.,in the area of covered porches that exceed 1Q% of the size of the residence/aces, structures. % BUILDING PAD COVERAGE 90 39Vd a vovw BEtbTLL09L 60:tZ 900Z/L0/90 • • QWNER'S A.CKNOWX.,EDGEMENT Property development in Rolling Hills is governed by ordinances of the CfTY 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 %c " )C; ,-// , California this 9 '' - day of A , ,2O . By: 2,4-2 o C-fir), Address 2,/3, Y � £ 9Ua-7 City 90 3Jdd apndgdw 88IbCLLO9L 60:7 900Z/L0/90 OWNER'S DECLARATION I (We) declare under penalty of perjury that the foregoing is true and correct. Executed at , 0 L /: 7c y /-//4 e this 9 ?- day of /%) V' By: By: 24 a o COL r / , Address A), f), V C'a' , �) 62 7 City . California, 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: 6, Pr r7 gh) DATE FILED REPRESENTATIVE: -14 FEE: COMPANY NAME:' J 43 4 7-0A)6)6', RECEIPT NO: COMPANY ADDRESS: BY: 7 7 ,`:> ZONING' CASE NO G, ("a, 62(z 7 4- TENTATIVE HEARING DATE: COMPANY PHONE NO. (3' / - 6 7/ ) PROJECT ADDRESS: Cie) i?c c^ /"26r / /GG s 9e Z "7 L0 3E d G FIdEdW BETtILL09L 60:TZ 900Z/LO/90 st • • REOUEST FOR HEARING FOR SITE PLAN REVIEW NOTE: According to Section 17.24.020 of the Rolling Hills Municipal Code, illegal uses or structures are required to be made conforming or shall be removed Therefore, you may be required to modifr or remove any unauthorized or unlawfirl use or structure on your property prior to or in conjunction with this application. In addition. pursuant to Resolution No. 900 of the City Council. any use or structure which would require a discretionary permit but which is conducted without the acquisition of said permit. shall be subject to retroactive discretionary permit process, and is subject to higher application fee. PROPERTY OWNER: OWNER'S ADDRESS: TELEPHONE NO: PROPERTY'S ADDRESS: LEGAL DESCRIPTION: AGENT'S NAME: AGENT'S ADDRESS: TELEPHONE NO: 24Z O 47, p. ✓, r 90 z 7 (3/0) 488 7320 7 LOT NO. 7 9 ASSESSORS BOOK NO. 756,7 PAGE U 0,3 PARCEL ©_ , d 7c)A) 670 C-r/A)e- 7 //\2 7 7 v 7 S ���/cam -S�cJ� , �/� �� , 9 z 74 (3►co) 5 ¢4-`6D/0 NATURE OF PROPOSED PROJECT Describe in detail the nature of the proposed project, including what aspects of the project require a Site Plan Review: `=i I /4 — /2 (2-5 67/s PJ/�il� Describe and delineate on plans any new basement area square footage /l/. A • • SITE PLAN 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 tivith the General Plan, the Zoning Ordinance and surrounding uses? Explain how it compares to the sizes, setbacks and other characteristics of neighboring houses. J 5 i DNS c/ i= r�,4e 4 S -�-��3 53 B. How does the project preserve and integrate into the site design. to the maximum extent feasible, existing natural topographic features of the lot including surrounding native vegetation, mature trees, drainage courses, and land forms (such as hillsides and knolls)? Explain how the project preserves and integrates existing natural features. ./%ii✓D//irr lS S /�T G //Y i c9 ///lam 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 or redirect drainage flow unless into an existing drainage course. Explain the nature and extent of the impact of grading and proposed minimization on lots. /4Sl S/iG /S /)L.(9«/7 f r �e /) z-7) / N/4/ 7i )/_l 7 % D. To what extent does the site development plan preserve surrounding native vegetation and supplement it with landscaping that is compatible with and enhances the rural character of the community? Landscaping should provide a buffer and transition zone between private and public areas. Explain how the project preserves native vegetation, integrates landscaping and creates buffers. z_z_ 4- A/(7 /,1 �.� CC r/—�l3 CL� Gam'/e7- Gr SL /7 5/ r G L.4/12/7."1-5- C"/—) • • E. How does the site development plan preserve the natural and undeveloped state of the lot by minimizing building 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. ET /1-70 cis (=r //ate < r/-1 / L-: iv/n) ice A/) X/5 "//l/����C 5(---D/9Z' /A) 7--/C-= /=,edA? i i-- />R() 7c= 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 where necessary to assure proportionality and openness. Explain how the proposed project setbacks compare with the existing setbacks of neighboring properties. %///% / ' ? /'_ S % CJ /� G �G Cc) S%/4 G L-' f /O /� G e/c- )/ 77 /i/(% 27 �Gll�iacK d / % bz-z / //��C��' %4// 7 2//& /z_)/, ) JiJ/z-c- 0/Ye (3 7..e (15-1 / 51 -/ //<'c, sL/7 LO c'.<1 -iv/,.) G. Is the site development plan sensitive and not detritnental to convenience and safety of circulation for pedestrians and vehicles? Explain how the number and types of vehicles relate to the driveway location, design, landscaping and other on -site parking or storage areas. Z:5 /ate ��ri/� > �-���� ///4 ///,t) s /?e/1 /1 X" i/)/LL /3G /)C H. Does the site development plan conform with the requirements of the California Environmental Quality Act? Explain how the project impacts the environment, e.g. significant impact, proposed mitigation measures. //�� e/ J/t)/GG /C it)f� L— /_/— C G • • 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 arean correct t to the best of my knowledge and belief. Date: '5 ` 5 - O Co FILING FEE r Signature" For: .fir � �E—/0 Applicant A filing fee must accompany the application. Make check payable to: CITY OF ROLLING HILLS BOLTON ENGINEERING PAGE 01 ab/31/2006 14:06 310-544-0458 • )E/Lj1 J INCORPORATED JANUARY 24, 1957 NCE REQU,L FOR HEARING NOTE: According to Section 17.24.020 of the Rolling Hills Municipal Code, illegal uses or structures are required to be made conforming or shall be removed. Therefore, you may be required to nnodj or remove any unauthorized or unlawful use or structure on your property prior to or in conjunction with this application. In addition, pursuant to Resolution No. 900 of the City Council, any use or structure which would require a discretionary permit but which is conducted without the acquisition of said permit, shall be subject to retroactive discretionary permit process, and is subject to higher application fee. PROPERTY OWNER: ' P C T)L K) OWNER'S ADDRESS: 2_4 2- () Co ,P J. C a, , 9 v 2 7 TELEPHONE NO.: i3 (U) 4- - i 3 2 PROPERTY ADDRESS: 0 v i - 2 LEGAL DESCRIPTION: LOT NO. 7 9 ASSESSOR'S BOOK NO. 7„, .6,, `7 PAGE n 0 -3 PARCEL d 3 6 AGENT'S NAME: u c_ c E t•-) C.-7 c 2 k AGENT'S ADDRESS: 7 r� -7 1 Lk/C.; n U (2-_, C2, 1-t C=, C-a_ 9 G Z-7 4.- TELEPHONE NO.: (31 0 1 NO. 2 PORTUGUESE BEND ROAD ROLLING WILLS, CALIF. 90274 (310) 377-1521 FAX: (310) 377.728E E•m�el: clty0frh@aol.com Describe in detail the nature of the proposed use, including what aspects clf the project require a Variance. i A I i t-t U 10 7 4r)'-t P D S Tr3 (> c Printed can Recycled r'tt- 03/31/200E 14:06 310-544-0458 Criteria to be satisfied for r Variance BOLTON ENGINEERING PAGE 02 • Such change is based uponthe followiing described exceptional or extraordinary circumstances or conditions that do not apply generally to other property in the same vicinity and zone. 1,\ it_k Lti1��� Lr C1--.1 t c•->� tip) 0 t— i t e Such change will not be materially detrimental to the public welfare nor injurious to the property or improvements in such vicinity and zone where property is located because k T AA) (L c_ l—i (-k '/ 1= 17 i= [ c i FILING FEE A fling fee must accompany the application. Make check payable to: CITY OF ROLLING HILLS, • • DATE 9--5- 0 (A ZONING CASE NO. ADDRESS 7 0 J T 1Z l D ES ALL STRUCTURES MUST BE SHOWN ON THE PLAN CALCULATION OF LOT COVERAGE AREA AND STRUCTURES NET LOT AREA RESIDENCE GARAGE SWIMMING POOL/SPA POOL EQUIPMENT GUEST HOUSE CABANA STABLE (dirt volume to be included in grading quantities) RECREATION COURT ATTACHED COVERED PORCHES ENTRYWAY/ PORTE COCHERE, BREEZEWAYS ATTACHED TRELLISES *DETACHED STRUCTURES: (circle all that applies) SHEDS, TRELLISES, GAZEBO, BARBECUE, OUTDOOR KITCHEN, ROOFED PLAY EQUP.- over 15 ft. high and over 120 sq. ft. in area, WATER FEATURES, ETC. SERVICE YARD OTHER BASEMENT AREA (volume to be included in grading quantities) DEPTH OF BASEMENT EXISTING "37, 3 2 0 sq.ft. 4-443 3 sq.ft. 'S 40 sq.ft. sq.ft. 6 4 sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. PROPOSED sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. TOTAL 3 7,3 20 44 S 3 540 7c3E3 4- sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. g 12 sq.ft. 12 sq.ft. sq.ft. sq.ft. l q 'a sq.ft. sq.ft. 14e TOTAL STRUCTURES % STRUCTURAL COVERAGE TOTAL STRUCTURES EXCLUDING UP TO 5 & UP TO 600 sq. ft. detached structures that are not higher than 10 ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. 1p 3 3 4 sq.ft. 1 1.0 % sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. I '2-- sq.ft. Z.4 % sq.ft. 148 sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. 7 2 4 to sq.ft. tc 4 % sq.ft. % STRUCTURAL COVERAGE • • ALL FLATWORK MUST BE SHOWN ON THE PLAN PRIMARY DRIVEWAY(S) 3 5 2- 7 sq.ft. sq.ft. 3 5 27 sq.ft. PAVED WALKS, PATIO AREAS, COURTYARDS 2`2' 1 sq.ft. sq.ft. 2 8 1 sq.ft. POOL DECKING 24-7 8 sq.ft. sq.ft. 24-7 8 sq.ft. OTHER PAVED DRIVEWAYS, ROAD EASEMENTS, PARKING PADS TOTAL FLATWORK % TOTAL FLATWORK COVERAGE TOTAL STRUCTURAL & FLATWORK COVERAGE % TOTAL COVERAGE sq.ft. 6 2-S C2 sq.ft. sq.ft. sq. ft. sq.ft. (o Z 2, 6 sq.ft. % Ito6 % 12, (c20 sq.ft. sq.ft. t3, 3 2 sq.ft. 33, v % % 3CA3 % TOTAL STRUCTURAL & FLATWORK COVERAGE sq.ft. sq.ft. sq.ft. Excl. the allowance of up to 5 — 600 sq. ft. structures from previous page. % TOTAL COVERAGE % % % TOTAL DISTURBED AREA _ • 1 ci 7 I '?, - sq.ft. sq.ft. I 7 I f, sq.ft. % DISTURBED AREA 4-2 . I % % 4 2 1 • % GRADING QUANTITY , (.0C) cubic yards (include future stable, corral and access way; basement and all other areas to be graded) All structures (attached and detached) must be listed. * Free standing accessory structures such as sheds, trellises, covered patios, gazebo, fountains, barbecue, outdoor fire place, etc., are not counted towards coverages and disturbed area, unless their combined area exceeds 600 sq. ft., or if there are more than 5 such structures on the property. Masters/Forms/Variance- Rev.2006 • DATE C — 0 Z . C . NO . ADDRESS 7 L L1 C I. TD C CALCULATION OF BUILDING PAD COVERAGE PAD NO. 1 BUILDABLE PAD AREA EXISTING PROPOSED TOTAL AND STRUCTURES BUILDING PAD t9.55 sq.ft. cq.ft. 19,5'78 sq ft RESIDENCE 44B3cq,ft, sq.ft. 4483 sq.ft. GARAGE 540 cq. ft_ sq.ft. 'S 40 sq.ft. POOL/SPA 7 6 S sq.ft. sq.ft. % S S cq.ft. POOL EQUIPMENT 84 cq.ft. sq.ft. GI sq.ft. CABANA/REC.RM sq.ft. sq.ft. sq.ft. GUEST HOUSE sq.ft. sq.ft. sq.ft. STABLE sq.ft. ` [ 2 sq.ft. l 2 cq,ft. SPORTS COURT sq.ft. sq.ft. sq.ft. SERVICE YARD (o sq.. sq.ft. 9 6 sq.ft. ATTACHED COVERED PORCHES _ _ Primary residence 1 `� cq.ft. sq.ft. 1.`D sq.ft. Accessory structures sq.ft. sq.ft. sq.ft. AREA OF ATTACHED COVERED sq.ft. sq.ft. sq.ft. PORCHES THAT EXCEED Io% OF THE SIZE OF RESIDENCE/ACCS. STRUCTURE ENTRYWAY/PORTE COCHERE/ BREEZEWAY ATTACHED TRELLISES ALL DETACHED STRUCTURES (from 1" page) ALL DETACHED STRUCTURES (from Pt page not including allowed deductions) OTHER 148 sq.ft. sq.ft. L 4B sq.ft. sq.ft. sq.ft. cq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. TOTAL STRUCTURES ON PAD NO. 163 34 sq.ft. t 2 sq.ft. 724 (osq.ft. % BUILDING PAD COVERAGE aJ 2. 4 % % 37. 0 % TOTAL STRUCTURES ON PAD NO. 1 Ci 9 01 sq.ft. sq.ft. 0 3 sq.ft. Not incl. attached trellises, Not incl. allowed deductions, and incl. the area of covered porches that exceed 10% of the size of the residence/aces. structures. % BUILDING PAD COVERAGE 30.(o% To 3 % • • 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 r L rf'•)C7 A/7 , California day of / 7, / , 20 0 . By: By: 2. 4 Z O C 0 Address a , P, V 9O2-7 City • • OWNER'S DECLARATION I (We) declare under penalty of perjury that the foregoing is true and correct. Executed at 1 L /_/ this 9 fh day of l`//1 By: By: , California, ,20 C� 24 20 CoL r /20, Address P V,, rd, 9 Z. 7 5- City 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 infornzation accompanying this application is true to the best of his (its) knowledge and belief Attach appropriate acknowledgment here. APPLICANT: 3' /7CT7E/) DATE FILED REPRESENTATIVE: -0O-c7 /%-c///.J 7 i /z FEE: COMPANY NAME: o G 7 c ) ')& RECEIPT NO: COMPANY ADDRESS: BY: 7 0 7 c76-- '-/‘/A7. A7L7 ZONING CASE NO A / /; (cam 96 Z 7 i/ TENTATIVE HEARING DATE: COMPANY PHONE NO. (.3 / o 5"44Z-G o/U PROJECT ADDRESS: /20 c_�//>/�/Gz-s City 0/l2 Rollin INCORPORATED JANUARY 24, 1957 NO. 2 PORTUGUESE BEND ROAD ROLLING HILLS, CALIF. 90274 (310) 377.1521 FAX: (310) 377-7288 E-mail: cityofrh@aol.com ENVIRONMENTAL INFORMATION FORM (To Be Completed By Applicant) Date Filed Zoning Case No. GENERAL INFORMATION 1. Applicant(s) 5 r. P G i1 1= r\) Tel. ('%+ ) 4- 7 3 Z (7 Address % 0 0 i R 1CD G 2 2. Legal Owner(s) ' . P CL fl E-- Tel. ( ) L{ - 7 7 Zc' Address 24- ZC C � T (-7 r ti) r ‘7 , Ca- c> ° L 7 6'— 3. Project Address 7 o 0 T 2 t n t �. Assessor's Book No. 7 6 -7 - 00,3 - 036, Lot No. `7 c) 4. Other related permits and other public approvals required for this project, including those required by city, regional, state and federal agencies: (Z, ,G(Ab LA CO PO 5. Existing zoning district Q A S -- 6. Proposed project/use of site (C) E i4 L. PROJECT DESCRIPTION 7. Site size c) /A C ti 8. Net lot area -3 7 t 3 0 f4,"Net Lot Area" means the total area included within the lot lines of the lot or parcel of property, exclusive of: (a) the entire area within a recorded roadway easement plus the area within ten (10) feet measured perpendicular to the edge of the roadway easement; (b) the ten (10) foot perimeter of the lot perpendicular to the property lines; (c) any private drive or driveway that provides access to any other lot or parcel; and (d) the access strip portion of a flag lot. I! 9. Total square footage of structures 7 2- 10. Number of floors of construction 11. Basement square footage I-1 February 2002 Environmental Information Form ®Printed on Hicyr�.lcd I+.gv,;r • 12. Total combined flatwork and structural lot coverage 13. Will any exterior walls be removed or relocated? Which walls? 1\1 0 14. Will any interior walls be removed or relocated? Which walls? M 0 15. Will the entire building structure require a new roof? 1/ C 16. Will the existing roof remain intact, with less than 200 square feet added? 17. Driveway Access and Parking: a. Is a new driveway accessway proposed? ('.) 0 (Requires Traffic Commission Review). b. Number of driveway(s) Existing? N 1. Proposed? (Second driveway requires approved Conditional Use Permit from Planning Commission). c. Width of driveway(s) Existing? 1 t -1-, Proposed? (Maximum of 20 foot width unless approved by the Planning Commission). d. Does first 20 feet of driveway have a maximum grade of 7%? (Maximum of 7% for first 20 feet of driveway required). Existing? Proposed? e. Grade of driveway(s)? Existing? 2 06/0 Proposed? (Maximum of 12% unless approved by the Planning Commission). f. Has site plan been reviewed by Los Angles County Fire Protection Engineer to meet current driveway access requirements? Explain . x ( h ' l (\) c-1 t c^ (`rt r= Does driveway cover more than a maximum 20% of the area of the yard in which it is located? N.) 0 Explain h. Does uncovered parking area cover more than a maximum 10% of the area of the yard in which it is located? ,-) c) Explain Does vehicular accessway to stable and corral have a maximum slope of 25% or less? \/ L5 Stable and corral average vehicular access slope t%G4 T . j. Does property have an above ground garage with a minimum capacity of 2 cars? Ye ' With guest house a minimum of 3 cars? g• 18. Grading quantities shall be balanced. Amount cut l G7 Amount fill L (c C) . (Include any basement cut in grading quantities). 19. Area of disturbance. 40% of net lot area maximum; any remedial grading (temporary disturbance), any graded slopes and building pad areas, and any nongraded area where impervious surfaces will remain or are proposed to be added. Square feet 1 :1 ( . Percentage of Net Lot Area 4 Z 1 . 20. If residential, include the unit size. Square feet 4 3 February 2002 Environmental Information Form 1-2 • 21. 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. 22. If industrial, indicate the type of project, estimated employment per shift, and loading facilities. 23. If institutional, indicate the major function, estimated employment per shift, estimated occupancy, loading facilities, and community benefits to be derived from the project. 24. Attach plans. 25. Proposed scheduling. 1\11 26. If the project involves a site plan review, variance, conditional use or rezoning application, state this and indicate dearly why the application is required. VARIAk\CL - f5'rUR_t3 r) AtCC,A -c a it.tA„) ENVIRONMENTAL SETTING 27. 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. February 2002 Environmental Information Form 1-3 • • 28. 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. 29. Is the proposed project consistent with: City of Rolling Hills General Plan Applicable Specific Plan City of Rolling Hills Zoning Ordinance South Coast Air Quality Management Plan Congestion Management Plan Regional Comprehensive Plan 30. Have any of the following studies been submitted? Geology Report Hydrology Report Soils Report Traffic Study Noise Study Biological Study Native Vegetation Preservation Plan Solid Waste Generation Report Public Services/ Infrastructure Report I - 4 Yes No N/A Historical Report Archaeological Report Paleontological Study Line of Sight Exhibits Visual Analysis Slope Map Fiscal Impact Analysis _ Air Quality Report Hazardous Materials/ Waste February 2002 Environmental Information Form • • Potentially Significant Impact Issues: Less Than Significant With Mitigation Incorporation Less Than Significant No Impact Impact L AESTHETICS — Would the project: a) Have a substantial adverse effect on a scenic vista? 0 0 0 Ei" b) Substantially damage scenic resources, including but 0 0 0 Et not limited to, trees, rock outcroppings, and historic buildings within a state scenic highway? c) Substantially degrade the existing visual character or 0 0 0 07 quality of the site and its surroundings? d) Create a new source of substantial light or glare which ❑ 0 ❑ would adversely affect day or nighttime views in the area? II. AGRICULTURE RESOURCES: In determining whether impacts to agricultural 0 0 0 0—" resources are significant environmental effects, lead agencies may refer to the California Agricultural Land Evaluation and Site Assessment Model (1997) prepared by the California Dept. of Conservation as an optional model to use in assessing impacts on agriculture and farmland. Would the project: / a) Convert Prime Farmland, Unique Farmland, or 0 0 0 C Farmland of Statewide Importance (Farmland), as shown on the maps prepared pursuant to the Farmland Mapping and Monitoring Program of the California Resources Agency, to non-agricultural use? b) Conflict with existing zoning for agricultural use, or a 0 0 0 EV Williamson Act contract? c) Involve other changes in the existing environment 0 0 0 which, due to their location or nature, could result in conversion of Farmland, to non-agricultural use? III. AIR QUALITY — Where available, the significance criteria established by the applicable air quality management or air pollution control district may be relied upon to make the following determinations. Would the project: a) Conflict with or obstruct implementation of the applicable air quality plan? 0 ❑ 0 Q February 2002 Environmental Information Form 1-6 • • Less Than Potentially Significant i� Less Than Significant Mitigation Significant No Impact Incorporation Impact Impact b) Violate any air quality standard or contribute ❑ 0 ❑ fIV substantially to an existing or projected air quality violation? c) Result in a cumulatively considerable net increase of 0 0 0 0/ any criteria pollutant for which the project region is non -attainment under an applicable federal or state ambient air quality standard (including releasing emissions which exceed quantitative thresholds for ozone precursors? d) Expose sensitive receptors to substantial pollutant 0 0 0 l/ concentrations? e) Create objectionable odors affecting a substantial 0 ❑ 0 10/ number of people? IV. BIOLOGICAL RESOURCES = Would the project: / a) Have a substantial adverse effect, either directly or 0 CI CI E through habitat modifications, on any species identified as a candidate, sensitive, or special status species in local or regional plans, policies, or regulations, or by the California Department of Fish and Game or U.S. Fish and Wildlife Service? b) Have substantial adverse effect on any riparian habitat ❑ 0 0 ID/ or other sensitive natural community identified in local or regional plans, policies, regulations or by the California Department of Fish and Game or U.S. Fish and Wildlife Service? c) Have a substantial adverse effect on federally 0 0 0 11/ protected wetlands as defined by Section 404 of the Clean Water Act (including, but not limited to, marsh, vernal pool, coastal, etc.) through direct removal, filling, hydrological interruption, or other means? d) Interfere substantially with the movement of any native 0 0 0 f2 resident or migratory fish or wildlife species or with established native resident or migratory wildlife corridors, or impede the use of native wildlife nursery sites? e) Conflict with any policies or ordinances protecting 0 0 0 0 biological resources, such as a tree preservation policy or ordinance? f) Conflict with the provisions of an adopted Habitat ❑ 0 ❑ IV Conservation Plan, Natural Community Conservation Plan, or other approved local, regional, or state habitat conservation plan? February 2002 Environmental Information Form 1-7 • • Potentially SiLess Than - gnificant With Less Than Significant Mitigation Significant No Impact Incorporation Impact Impact V . CULTURAL RESOURCES —Would the project: a) Cause a substantial adverse change in the significance ❑ 0 ❑ of a historical resource as defined in §15064.5 of the State CEQA Guidelines? b) Cause a substantial adverse change in the 0 0 0 111/ significance of an archaeological resource pursuant to §15064.5 of the State CEQA Guidelines? c) Directly or indirectly destroy a unique paleontological 0 ❑ 0 I3 resource or site or unique geologic feature? d) Disturb any human remains, including those interred 0 ❑ 0 07 outside of formal cemeteries? VI. GEOLOGY AND SOILS — Would the project: a) Expose people or structures to potential substantial adverse effects, including the risk of Toss, injury, or death involving: / i) Rupture of a known earthquake fault, as delineated 0 0 El9 on the most recent Alquist-Priolo Earthquake Fault Zoning Map issued by the State Geologist for the area or based on other substantial evidence of a known fault? Refer to Division of Mines and Geology Special Publication 42. ii) Strong seismic ground shaking? 0 ❑ 0 01 iii) Seismic -related ground failure, including ❑ 0 ❑ 13'. liquefaction? iv) Landslides? 0 0 0 b) Result in substantial soli erosion or the loss of topsoil? 0 0 0 EV c) Be located on a geologic unit or soil that is unstable, 0 0 0 DV or that would become unstable as a result of the project, and potentially result in on- or off -site landslide, lateral spreading, subsidence, liquefaction or collapse? d) Be located on expansive soil, as defined in Table 18- 0 ❑ ❑ 1 B of the Uniform Building Code (1994), creating substantial risks to life and property? e) Have soils incapable of adequately supporting the ❑ 0 0 use of septic tanks or alternative waste water disposal systems where sewers are not available for the disposal of waste water? February 2002 Environmentaf Information Form 1-8 Potentially Less Than significant Significant With Impact imitigncorporation rporation VII. HAZARDS AND HAZARDOUS MATERIALS - Would the project: a) Create a significant hazard to the public or the environment through the routine transport, use, or disposal ofhazardous materials? b) Create a significant hazard to the public or the 0 ❑ ❑ environment through reasonably foreseeable upset and accident conditions involving the release of hazardous materials into the environment? c) Emit hazardous emissions or handle hazardous or 0 0 ❑ I acutely hazardous materials, substances, or waste within one -quarter mile of an existing or proposed school? d) Be located on a site which is included on a list of 0 0 0 E hazardous materials sites compiled pursuant to Government Code Section 65962.5 and, as a result, would it create a significant hazard to the public or the environment? e) For a project located within an airport land use plan 0 ❑ ❑ l" or, where such a plan has not been adopted, within two miles of a public airport or public use airport, would the project result in a safety hazard for people residing or working in the project area/ f) For a project within the vicinity of a private airstrip, ❑ ❑ ❑ would the project result in a safety hazard for people residing or working in the project area? g) Impair implementation of or physically interfere with an ❑ ❑ ❑ adopted emergency response plan or emergency evacuation plan? h) Expose people or structures to a significant risk of ❑ ❑ 0 loss, injury or death involving wildland fires, including where wildlands are adjacent to urbanized areas or where residences are intermixed with wildlands? Less Than Significant No Impact Impact ❑ ❑ ❑ D� L9/ February 2002 Environmental Information Form 1-9 Less Than Potentially Significant With Less Than Significant Mitigation Significant No Impact Incorporation Impact Impact VI11. HYDROLOGY AND WATER QUALITY — Would the project: a) Violate any water quality standards or waste discharge 0 0 0 EY requirements? b) Substantially deplete groundwater supplies or 0 0 0 07 interfere substantially with groundwater recharge such that there would be a net deficit in aquifer volume or a lowering of the local groundwater able level (e.g., the production rate of preexisting nearby wells would drop to a level which would not support existing land uses or planned uses for which permits have been granted? c) Substantially alter the existing drainage pattern of the 0 0 0 0/ site or areas including through the alteration of the course of a stream or river, in a manner which would result in substantial erosion or siltation on- or off -site? d) Substantially alter the existing drainage pattern of the 0 0 0 07 site or areas including through the alteration of the course of a stream or river, in a manner which would result in flooding on- or off -site? e) Create or contribute runoff water which would exceed 0 0 0 IV the capacity of existing or planned storm water drainage systems or provide substantial additional sources of polluted runoff? f) Otherwise substantially degrade water quality? 0 0 0 Ci g) Place housing within a 100-year flood hazard area as 0 0 0 Ci mapped on a federal Flood Hazard Boundary or Flood Insurance Rate map or other flood hazard delineation map? h) Place within a 100-year flood hazard area structures which would impede or redirect flood flows? i) Expose people or structures to a significant risk of Toss, injury or death involving flooding, including flooding as a result of the failure of a levee or dam? j) Inundation by seiche, tsunami, or mudflow? ❑ 0 0 0/ ❑ 0 0 lr ❑ 0 0 CV February 2002 Environmental Information Form 1-10 • • Potentially Sigma Than Withnt • Less Than Significant Mitigation Signfic t Impact InccfPcration Impact No Impact IL LAND USE AND PLANNING — Would the project: a) Physically divide an established community? ❑ ❑ 0 b) Conflict with any applicable land use plan, policy, or 0 0 ❑ IV regulation of an agency with jurisdiction over the project (including but not limited to the general plan,. specific plan, local coastal program, or zoning ordinance) adopted for the purpose of avoiding or mitigating an environmental effect? c) Conflict with any applicable habitat conservation plan or natural community conservation plan? X. MINERAL RESOURCES — Would the project: a) Result in the Toss of availability of a known mineral resource that would be of value to the region and the residents of the state? b) Result in the loss of availability of a locally -important mineral resource recovery site delineated on a local general plan, specific plan or other land use plan? XI. NOISE— Would the project result in: a) Exposure of persons to or generation of noise levels in excess of standards established in the local general plan or noise ordinance, or applicable standards of other agencies? b) Exposure of persons to or generation of excessive groundborne vibration or groundborne noise levels? c) A substantial permanent increase in ambient noise levels in the project vicinity above levels existing without the project? d) A substantial temporary or periodic increase in ambient noise levels in the project vicinity above levels existing without the project? e) For a project located within an airport land use plan or, where such a plan has not been adopted, within two miles of a public airport or public use airport, would the project expose people residing or working in the project area to excessive noise levels. f) For a project within the vicinity of a private airstrip, would the project expose people residing or working in the project area to excessive noise levels? ❑ ❑ ❑ ❑ 0 ❑ LR ❑ 0 0 l� ❑ 0 0 07 ❑ 0 0 LV ❑ 0 0 ❑ ❑ ❑ CT ❑ ❑ 0 0' ❑ 0 0 El February 2002 Environmental Information Form • • Less Than • Potentially significant With Less Than Significant Mitigation Significant Impact Incorporation Impact No Impact XII. POPULATION AND HOUSING— Would the project: a) Induce substantial population growth in an area, either 0 0 0 19' directly (for example, by proposing new homes and businesses) or indirectly (for example, through extension of roads or other infrastructure)? b) Displace substantial numbers of existing housing, ❑ 0 0 0" necessitating the construction of replacement housing elsewhere? c) Displace substantial numbers of people, necessitating ❑ 0 0 13{ the construction of replacement housing elsewhere? XIII. PUBLIC SERVICES a) Would the project result in substantial adverse physical impacts associated with the provision of new or physically altered governmental facilities, need for new or physically altered governmental facilities, the construction of which could cause significant environmental impacts, in order to maintain acceptable service ratios, response times or other performance objectives for any of the public services: Fire protection? 0 0 0 Police protection? 0 0 0 Ely Schools? 0 0 0 C 7 Parks? 0 ❑ 0 1:1� Other public facilities? 0 ❑ 0 O/ XIV. RECREATION a) Would the project increase the use of existing ❑ 0 0 neighborhood and regional parks or other recreational facilities such that substantial physical deterioration of the facility would occur or be accelerated? b) Does the project include recreational facilities or 0 0 ❑ require the construction or expansion of recreational facilities which might have an adverse physical effect on the environment? February 2002 Environmental Information Form 1-12 Potentihially Less Than SignificantaySignificant Wrth Mitigation Impact Incorporation Less 'Than Significant No Impact Impact XV. TRANSPORTATION/TRAFFIC —Would the project: a) Cause an increase in traffic which is substantial in 0 ❑ ❑ relation to the existing traffic Toad and capacity of the street system (i.e., result in a substantial increase in either the number of vehicle trips, the volume to capacity ratio on roads, or congestion at intersections? b) Exceed either individually or cumulatively, a level of ❑ 0 0 t9' service standard established by the county congestion management agency for designated roads or highways? • c) Result in a change in air traffic patterns, including either ❑ ❑ 0 La/ an increase in traffic levels or a change in location that results in substantial safety risks? d) Substantially increase hazards due to a design feature 0 ❑ ❑ 0/ (e.g., sharp curves or dangerous intersections) or incompatible uses (e.g., farm equipment)? e) Result in inadequate emergency access? ❑ ❑ ❑113/ f) Result in inadequate parking capacity? 0 ❑ 0 13 g) Conflict with adopted policies, plans, or programs 0 0 0 supporting alternative transportation (e.g., but turnouts, bicycle racks)? XVI. UTILITIES AND SERVICE SYSTEMS — Would the project: a) Exceed wastewater treatment requirements of the ❑ 0 0 L applicable Regional Water Control Board? b) Require or result in the construction of new water or 0 ❑ ❑ 1217 wastewater treatment facilities or expansion of existing facilities, the construction of which could cause significant environmental effects? c) Require or result in the construction of new storm 0 0 ❑ Er water drainage facilities or expansion of existing facilities, the construction of which could cause significant environmental effects? d) Have sufficient water supplies available to serve the 0 0 0 CC project from existing entitlements and resources, or are new or expanded entitlements needed? February 2002 Environmental Information Form 1-13 e) Result in a determination by the wastewater treatment provider which serves or may serve the project that it has adequate capacity to serve the project's projected demand in addition to the provider's existing commitments? f) Be served by a landfill with sufficient permitted capacity to accommodate the project's solid waste disposal needs? g) Comply with federal, state, and local statutes and regulations related to solid waste? XVII. STORM WATER QUALITY IMPACTS —Would the project: r. a) During construction result in potential impact on storm water runoff? b) Post -construction result in potential impact on storm water runoff? c) Result in potential for discharge of storm water from areas from material storage, vehicle or equipment fueling, vehicle or equipment maintenance (including washing), waste handling, hazardous materials handling or storage, delivery areas or loading docks, or other outdo( work areas? d) Result in potential for discharge of storm water to impair the beneficial uses of the receiving waters or areas that provide water quality benefit? e) Result in potential for discharge of storm water to cause significant harm on the biological integrity of the waterways and water? f) Result in potential for significant changes in the flow velocity or volume of storm water runoff that can cause environmental harm? g) Result in potential for significant increases in erosion of the project site or surrounding areas? Potentially Significant Impact Las, Than Significant With Mitigation Incorporation Less Than Significant No Impact Impact ❑ ❑ esY ❑ o 0 O ❑ ❑ ❑ 0 0 ❑ ❑ 0 0 0 0 ❑ 0 ❑ ❑ ❑ 0 ❑ 0 0 ❑ 0 0 ❑2 February 2002 Environmental Information Form 1-14 PotentiallyLess Than L ess Than Significant Significant � mitigation Significant No Impact Incorporation Impact Impact XVIII. MANDATORY FINDINGS OF SIGNIFICANCE a) Does the project have the potential to degrade the ❑ ❑ 0 1 ✓ 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 impacts that are individually ❑ ❑ ❑ ®� limited, but cumulatively considerable? ("Cumulatively considerable" means that the incremental effects of a project are considerable when viewed in connection with the effects of past projects, the effects of other current projects and the effects of probable future projects.) c) Does the project have environmental effects which ❑ ❑ ❑ C9' will cause substantial adverse effects on human beings, either directly or indirectly? February 2002 Environmental Information Form 1-15 • • NOTE: In the event that the project site and any alternatives are not listed on any list compiled pursuant to Section 65962.5 of the Government Code, then the applicant must certify that fact as provided below. I have consulted the lists compiled pursuant to Section 65962.5 of the Government Code and hereby certify that the development project and any alternatives proposed in this application are not contained on these lists. Date 3-3i- Off, —Vire Signature 0 For 19/77C Al 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 7- 3 / - For Signatur-' S, �A) Applicant 1-17 February 2002 Environmental Information Form