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756, Lot Line adjustment between 17, ApplicationC1iy o/ RO//L5L Jh/1 INCORPORATED JANUARY 24, t957 NO. 2 PORTUGUESE BEND ROAD ROLLING HILLS, CALIF. 90274 VARIANCE (310) 377-1521 REOUEST FOR HEARING FAX: (310) 377-7288 E-mail: cityotrh@aol.com 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 modh' or remove any unauthorized or unlaitful 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: Cc it•t ()4, 6. C OWNER'S ADDRESS: I .a Aft6 0x.1 r u U 'u TELEPHONE NO.: 310 . (c ( ! 76R PROPERTY ADDRESS: SQ_t,,..st_ S �� LEGAL DESCRIPTION: LOT NO. G ASSESSOR'S BOOK NO. % 567 PAGE o ( S PARCEL P..+Z .ga-r ( AGENT'S NAME: AGENT'S ADDRESS: TELEPHONE NO.: Describe in detail the nature of the proposed use, including what aspects of the project require a Variance. 1. To resolve a property line dispute, the owners of 17 Georgeff Road agreed to purchase the piece of land in dispute from the owners of 19 Georgeff Road. This variance addressed the consequence of the Lot Line Adjustment. After the purchase, for the property on 17 Georgeff Road, the Net Area considered by the City of Rolling Hills would change from 0.8054 acres to 0.847 acres For the property on 19 Georgeff Road, the Net Area (Rolling Hills) would change from 0.868 acres to 0.810 acres. Also, the distance from one corner of the house to the property line would change from 23 feet to 13 feet. 2. Expansion of the 17 Georgeff driveway by 100 square feet ®Pr" Ilea ore Recycled Pity&' Criteria to be satisfied for rant otikriance • Such change is based upon the following described exceptional or extraordinary circumstances or conditions that do not apply generally to other property in the same vicinity and zone. 1. The adjusting of the lot line to the swale makes topographic sense resulting in the owners of 17 Georgeff Road owning the piece of land in dispute, thereby giving them the - complete responsibility to maintain the integrity of the entire hillside. The paddock area downhill has subsided before. 2. Originally, to back out from our garage, we had to continue to back out onto Georgeff Road. We had a couple of concerns about traffic safety. There is a handicapped neighbor - who always drives around in a very low hand -cycle. It is very hard to see him when we are backing out onto the street. We have 3 teenagers. The 1 g year -old and 16-year-old are new drivers. The 15-year-old will be getting her permit later on this month. Georgeff Road goes down from our house on and turns. It is hard to see cars coming up, especially for inexperienced drivers. To alleviate these safety concerns, our driveway was expanded for 100 sq ft. The slightly curving out area allows 3-point back turn thereby vehicles can head out onto Georgeff instead ofbacking out. 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 1. The change only involves lot line adjustment. There is no physical change whatsoever. 2. The expansion of the driveway improves traffic safety FILING FEE A filing fee must accompany the application. Make check payable to: CITY OF ROLLING HILLS. Masters/Forms/Variance- Rev.2006 DATE • Z.C. NO. ADDRESS CALCULATION OF BUILDING PAD COVERAGE PAD NO. 1 ND `'VA-- PAT Qw,, cal,,,;,- ti:,-11 BUILDABLE PAD AREA EXISTING PROPSED AND STRUCTURES "tIgo sI, f'C IIUILDING PAD 1.1, a 6l sq.ft. I I ,161 sq,fr. RESIDENCE 4,670 sq.ft. ¢,17(2 sq.ft. GARAGE 5o ° sq.ft. 5a° sq.ft. POOL/SPA Sz 5 sq.ft. 505 'q.fr. POOL EQUIPMENT 65 sq.ft. C3 cq.ft. CABANA/REC.RM sq.ft. sq.ft. GUEST HOUSE sq.ft. sq.ft. STABLE sq.ft. sq.ft. SPORTS COURT sq.ft. sq.ft. SERVICE YARD 120 sq ft. 1 ID sq.ft. ATTACHED COVERED PORCHES Primary residence sq.ft. sq.ft. sq.ft. Accessory structures sq.ft. sq.ft. sn.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 sq.ft. sq.ft. sq.ft. ATTACHED TRELLISES sq.ft. sq.ft. sq.ft. ALL DETACHED STRUCTURES sq.ft. sq.ft. sq.ft. (from 1" page) ALL DETACHED STRUCTURES sq.ft. sq.ft. (from 1'` page not including allowed deductions) OTHER sq.ft. sq.ft. , rl"(1 4 k) • TOTAL STRUCTURES ON PAD NO. 1 5 7 sq fr. 90 BUILDING PAD COVERAGE TOTAL STRUCTURES ON PAD NO. 1 Not incl. attached trellises, Not incl. allowed deductions, and incl. the area of covered porches that exceed 10% of the size of the residence/accs. structures. % BUILDING PAD COVERAGE 5� g7 6 sq.ft. 5 2.(0 % 5e 7L'aq.ft. sq.ft. sq.fr, sq.ft. sq.ft. q.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. To ALL FLATWORK MUST BE SHOWN ON THE PLAN f i40 • PRIMARY DRIVEWAY(S) BOO sq.ft. sq.ft. sq.ft. PAVED WALKS, PATIO 3so 40a AREAS, COURTYARDS , oo sq.ft. sq.ft. sq.ft. POOL DECKING 147 S sq.ft. sq.ft. sq.ft. OTHER PAVED DRIVEWAYS, ROAD EASEMENTS, PARKING PADS sq.ft. -1- I n o sq.ft. sq. ft. TOTAL FLATWORK 4375 sq.ft. `" 1 00 sq.ft. .44. 2 5 sq.ft. % TOTAL FLATWORK COVERAGE 1 2:5 % D, zG % 12, , % L+ 6l36I4315) N1t6i TOTAL STRUCTURAL & 31 36111 FLATWORK COVERAGE I I. 061 sq.ft. -I-- t O. sq.ft. sq.ft. % TOTAL COVERAGE qi•5 % % 3D. 2 % 5 /36. + 4 525 �1 TOTAL STRUCTURAL & FLATWORK COVERAGE 1 0/4 I sq.ft. t (00 sq.ft. 1 (734-/ sq.ft. Excl. the allowance of up to 5 —goo sq. ft. structures from previous page. TOTAL COVERAGE 7-9 % TOTAL DISTURBED AREA sq.ft. sq.ft. sq.ft. % DISTURBED AREA GRADING QUANTITY (include future stable, corral and access way; basement and all other areas to be graded) cubic yards 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 exceeds69OO sq. ft., or if there are more than 5 such structures on the property. • •DZ� DATE q't 10 • ZONING CASE NO. ADDRESS / 7 ALL STRUCTURES MUST BE SHOWN ON THE PLAN CALCULATION OF LOT COVERAGE AREA AND STRUCTURES EXISTING PROPOSED NET LOT AREA 35 .° g4- sq.ft. 36, 913 sq.ft. sq.ft. RESIDENCE 4 C70 sq.ft. sq.ft. sq.ft. GARAGE co o sq.ft, sq.ft. sq.ft. SWIMMING POOL/SPA a stis sq.ft. sq.ft. sq.ft. POOL EQUIPMENT 6 3 sq.ft. sq.ft. sq.ft. GUEST HOUSE - sq.ft. sq.ft. sq.ft. CABANA sq.ft. sq.ft. sq.ft. STABLE (dirt volume to be included in grading quantities) Q 540 sq.ft. sq.ft. sq.ft. RECREATION COURT / sq.ft. sq.ft. sq.ft. ATTACHED COVERED PORCHES / sq.ft. sq.ft. sq.ft. ENTRYWAY/ PORTE COCHERE, BREEZEWAYS '� sq.ft. sq.ft. sq.ft. ATTACHED TRELLISES sq.ft. sq.ft. sq.ft. *DETACHED STRUCTURES: (circle all that applies) SHEDS, TRELLISES, GAZEBO, sq.ft. sq.ft. sq.ft. BARBECUE, OUTDOOR KITCHEN, sq.ft. sq.ft. sq.ft. ROOFED PLAY EQUP.- over 15 ft. sq.ft. sq.ft. sq.ft. high and over 120 sq. ft. in area, WATER FEATURES, ETC. 31 R- sq.ft. sq.ft. sq.ft. SERVICE YARD b 17.0 sq.ft. sq.ft. sq.ft. OTHER sq.ft. sq.ft. sq.ft. BASEMENT AREA / sq.ft. sq.ft. sq.ft. (volume to be included in grading quantities) DEPTH OF BASEMENT TOT"'`Lr TOTAL STRUCTURES 6.13 G sq.ft. 7"b sq.ft. sq.ft. % STRUCTURAL COVERAGE I 1 1 % ! % TOTAL STRUCTURES EXCLUDING UP TO 5 & •UP TO goo aitliksq. ft. detached structures that are not higher than 10 ft. • % STRUCTURAL COVERAGE Sq 36 sq.ft. 59 3 sq.ft. sq.ft. • • DATE PAD "O.2 Z.C. NO. ADDRESS CALCULATION OF BUILDING PAD COVERAGE BUILDABLE PAD AREA AND STRUCTURES EXISTING PROPOSED 7Fr BUILDING PAD sq.ft. sq.ft. sq.ft. RESIDENCE sq.ft. sq.ft. sq.ft. GARAGE sq.ft. sq.ft. sq.ft. POOL/SPA sq.ft. sq.ft. sq.ft. POOL EQUIPMENT sq.ft. sq.ft. sq.ft. CABANA/REC.RM sq.ft. sq.ft. sq.fr. GUEST HOUSE sq.ft. sq.ft. sq.fr. STABLE sq.ft. sq.ft. sq.ft. SPORTS COURT sq.ft. sq.ft. sq.ft. SERVICE YARD si.ft. sq.ft. sq.ft. ATTACHED COVERED PORCHES Primary residence sq.ft. sq.ft. sq.ft. Accessory structures sq.ft. sq.ft. sq.ft. AREA OF ATTACHED COVERED sq.ft. <.q.ft. sq.ft. PORCHES THAT EXCEED 10% OF THE SIZE OF RESIDENCE/ACCS. STRUCTURE ENTRYWAY/PORTE COCHERE/ BREEZEWAY sq.ft. sq.ft. sq.ft. ATTACHED TRELLISES sq.ft. sq.ft. sq.ft. ALL DETACHED STRUCTURES (from 1" page) sq.ft. sq.ft. sq.ft. ALL DETACHED STRUCTURES (from page nor including allowed sq.ft. sq.ft. sq.ft. deductions) OTHER sq.ft. sq.ft. sq.ft. TOTAL STRUCTURES ON PAD NO. 2 gilt. sq.ft. sq.ft. % BUILDING PAD COVERAGE �'a % Oo TOTAL STRUCTURES ON PAD NO. 2 sq.ft. sq.ft. sq.ft. Not incl. attached trellises, Not incl. allowed deductions, and incl. the area of covered porches that exceed (0% of the size of the residence/acts. structures. BUILDING PAD COVERAGE s • 47r I DATE 1 -1I 4 ZONING CASE NO. ADDRESS L (4e-5 tf:f6 ALL STRUCTURES MUST BE SHOWN ON THE PLAN CALCULATION OF LOT COVERAGE AREA AND STRUCTURES EXISTING PROPOSED TO74fi NET LOT AREA 3 7&( sq.ft. 3 5, Z E 7 sq.ft. RESIDENCE, 3 5 So sq.ft. sq.ft. GARAGE Sox 25 7 50 sq.ft. sq.ft. SWIMMING POOL/SPA ".1 . t zi'l _ *sq.ft. sq.ft. POOL EQUIPMENT sq.ft. sq.ft. GUEST HOUSE sq.ft. sq.ft. CABANA sq.ft. sq.ft. STABLE (dirt volume to be included in grading quantities) sq.ft. sq.ft. sq.ft. RECREATION COURT sq.ft. sq.ft. sq.ft. ATTACHED COVERED PORCHES sq.ft. sq.ft. sq.ft. ENTRYWAY/ PORTE COCHERE, BREEZEWAYS sq.ft. sq.ft. sq.ft. ATTACHED TRELLISES sq.ft. sq.ft. sq.ft. *DETACHED STRUCTURES: (circle all that applies) SHEDS, TRELLISES, GAZEBO, sq.ft. sq.ft. sq.ft. BARBECUE, OUTDOOR KITCHEN, sq.ft. sq.ft. sq.ft. ROOFED PLAY EQUP.- over 15 ft. sq.ft. sq.ft. sq.ft. high and over 120 sq. ft. in area, WATER FEATURES, ETC. sq.ft. sq.ft. sq.ft. SERVICE YARD )< (Z. 1 to sq.ft. sq.ft. sq.ft. OTHER sq.ft. sq.ft. sq.ft. BASEMENT AREA sq.ft. sq.ft. sq.ft. (volume to be included in grading quantities) DEPTH OF BASEMENT TOTAL STRUCTURES % STRUCTURAL COVERAGE TOTAL STRUCTURES EXCLUDING UP TO 5 & UP TO goo 6B sq. ft. detached structures that are not higher than 10 ft. STRUCTURAL COVERAGE 4 S55 sq.ft. la,'2 4.$Ss sq.ft. ►3.7 % sq.ft. sq. ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. °IA 43 sq.ft. sq.ft. G 2 ° 4- % PRIMARY DRIVEWAY(S) PAVED WALKS, PATIO AREAS. COURTYARDS POOL DECKING OTHER PAVED DRIVEWAYS, ROAD EASEMENTS, PARKING PADS TOTAL FLATWORK % TOTAL FLATWORK COVERAGE TOTAL STRUCTURAL & FLATWORK COVERAGE % TOTAL COVERAGE 5032 31,831 37S31 TOTAL STRUCTURAL & FLATWORK COVERAGE Excl. the allowance of up to 5 —goo sq. ft. structures from previous page. % TOTAL COVERAGE ALL FLATWORK MUST BE SHOWN ON THE PLAN sq.ft. f ‘ sq.ft. 41- sq.ft. zz sq.ft. sq.ft. G037- sq.ft. 13.E % 88 7 sq.ft. 2%. % 5o3?t43? 1Z� sq.ft. 24 % sq.ft. 7-4O sq.ft. sq.ft. sq.ft. 3. 3 % —' �a ti297 sq.ft. 4-2- . sq.ft. 3S 27 2..7 % TOTAL DISTURBED AREA sq.ft. sq.ft. % DISTURBED AREA GRADING QUANTITY (include future stable, corral and access way; basement and all other areas to be graded) sq.ft. sq.ft. sq. ft. sq. ft. sq. ft. sq.ft. sq.ft. sq.ft. cubic yards 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 exceedst9OO sq. ft., or if there are more than 5 such structures on the property. • DATE ill d Z.C. NO. ADDRESS • CALCULATION OF BUILDING PAD COVERAGE PAI) NO. 1 N d oli '- BUILDABLE PAD AREA EXISTING PROPOSED TO"E f 4 AND STRUCTURES BUILDING PAD C g-e / sq.ft. '461 gli sq.fr. 5q.ft. RESIDENCE 3 Ssv sq.ft. S(:)sq.ft. sq.fr. GARAGE 1 50 sq.fr. 159 sq.fr. cq.ft. POOL/SPA 4 S ' sq.ft. 459sq.ft. sq.ft. POOL EQUIPMENT sq.ft. cq.ft. cq.ft. CABANA/REC.RM sq.ft. sq.ft. cq.ft. GUEST HOUSE sq.ft. sq.ft. cq.ft. STABLE sq.fr. sq.ft. sq.ft. SPORTS COURT sq.ft. sq.ft. sq.ft. SERVICE YARD 9 6sq.ft. 1 (/ sq.ft. sq.ft. ATTACHED COVERED PORCHES Primary residence sq.ft. sq.ft. cq.ft. Accessory strictures sq.ft. sq.ft. sq.ft. AREA OF ATTACHED COVERED sq.ft. =q.ft. sq.fr. PORCHES THAT EXCEED ro% OF THE SIZE OF RESIDENCE/ACCS. STRUCTURE ENTRYWAY/PORTE COCHERE/ BREEZEWAY sq.ft. sq.ft. sq.ft. ATTACHED TRELLISES sq.ft. sq.ft. sq.ft. ALL DETACHED STRUCTURES sq.ft. sq.ft. sq.ft. (from 1" page) ALL DETACHED STRUCTURES Sq.ft. sq.fr. cq.ft. (from I' page not including allowed deductions) OTHER cq.ft. sq.ft. sq.ft. 5 TOTAL STRUCTURES ON PAD NO. 1 4 3yq� sq.ft. 6 S sq:ft. sq.ft. _._1 % BUILDING PAD COVERAGE _..% _% % TOTAL STRUCTURES ON PAD NO. 1 1" 85 5 sq.ft. 4 P.1 S sq.ft. 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/acts. structures. % BUILDING PAD COVERAGE • • (1(DATE Z.C. NO. ADDRESS 11 CALCULATION OF BUILDING PAD COVERAGE BUILDABLE PAD AREA AND STRUCTURES EXISTING PROPOSED BUILDING PAD sq.ft. sq.ft. sq.ft. RESIDENCE sq.ft. sq.ft. sq.ft. GARAGE sq.ft. sq.ft. sq.ft. POOL/SPA sq.ft. sq.ft. sq.ft. POOL EQUIPMENT sq.ft. sq.ft. sq.ft. CABANA/REC.RM sq.ft. sq.ft. sgSt. GUEST HOUSE sl.ft. sq.ft. sq.ft. STABLE sq.ft. sq.ft. sq.ft. SPORTS COURT , sq.ft. sq.ft. sq.ft. SERVICE YARD sq.ft. sq.ft. sq.ft. ATTACHED COVERED PORCHES Primary residence sq.ft. sq.ft. sq.ft. Accessory structures sq.ft. sq.ft. sq.ft. AREA OF ATTACHED COVERED sq.ft. sq.ft. sq.ft. PORCHES THAT EXCEED 10% OF THE SIZE OF RESIDENCE/ACCS. STRUCTURE ENTRYWAY/PORTE COCHERE/ BREEZEWAY sq.ft. sq.ft. sq.ft. ATTACHED TRELLISES sq.ft. sq.ft. sq.ft. ALL DETACHED STRUCTURES (from 1" page) sq.ft. sq.ft. sq.ft. ALL DETACHED STRUCTURES (from !"page not including allowed sq.ft. sq.ft. sq.fr. deductions) OTHER sq.ft. sq.ft. sq.ft. TOTAL STRUCTURES ON PAD NO. 2 sq.ft. sq.ft. sq.ft. % BUILDING PAD COVERAGE % To Ob TOTAL STRUCTURES ON PAD NO. 2 sq.ft. sq.ft. 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 r/o 90 rlo • • OWNER'S DECLARATION I (We) declare under penalty oflperjury that the foregoing is true and correct. th Executed at Y -`- t 1 5 , California, this 7 day of M a — el— , 20 By: Adds � ( 1 ile.e Arg 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 information accompanying this application is true to the best of his (its) knowledge and belief Attach appropriate acknowledgment here. APPLICANT: Cc- Yk DATE FILED REPRESENTATIVE: FEE: COMPANY NAME: RECEIPT NO: COMPANY ADDRESS: BY: ZONING CASE NO TENTATIVE HEARING DATE: COMPANY PHONE NO. ( ) PROJECT ADDRESS: ' 1 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 ( S , California this / a (;(-- day of-�- , 20 J I , ,e t °27 f- Address Li City U " V 90 2- 7 �-- CITY OF ROLLING HILLS ZONING CASE CERTIFIED PROPERTY OWNER'S LIST AFFIDAVIT STATE OF CALIFORNIA COUNTY OF LOS ANGELES CITY OF ROLLING HILLS ) §§ declare under penalty of perjury that the attached list contains the names and addresses of all persons to whom all property is assessed as they appear on the latest available assessment roll of the County within the area described and for a distance of one thousand (1,000) feet from the exterior boundaries of property legally described as: Executed at �`�' "`-1 % i i ( s this day of NetiA- Signature`s , California, ,20 • • Cep a/ R0/t JJdf INCORPORATED JANUARY 24, 1957 NO. 2 PORTUGUESE BEND ROAD `•L. ! ROLLING HILLS, CALIF. 90274 (310) 377-1521 REOUEST FOR HEARING FAX: (310) 377-7288 E-mail: cityolrh@aol.com ,VOTE: 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. Therefn-e. you may be required to nrochfi• or remove any unauthorized or rmlcritfnl use or structure on your property prior to or in conjunction with this application. !n addition, lrursuco:t to Resolution No. 900 of the City Council, ani• use or structure ivhich would require a discretionary permit but which is conducted without the acquisition of said permit. shall be subject 16 retroactive di.sc•relioncn-r permit process. and is subject to higher application fee. 4 A PROPERTY OWNER: OWNER'S ADDRESS: TELEPHONE NO.: VARIANCE PROPERTY ADDRESS: A a LEGAL DESCRIPTION: LOT NO. ASSESSOR'S BOOK NO. PAGE PARCEL AGENTS NAME: AGENT'S ADDRESS: TELEPHONE NO.: Describe in detail the nature of the proposed use, including what aspects of the project require a Variance. Request for Variance from the requirement of 1. one acre lots 2. width of lots to be 150 feet Proposed to 1. reduce the lot size requirement for the subject properties 2. reduce the lot width requirement of the subject properties ®Prit+ted Oft Criteria to be satisfied for Bran• Variance • Such change is based upon the following described exceptional or extraordinary circumstances or conditions that do not apply generally to other property in the same vicinity and zone. f To resolve a property line dispute, the owners of 17 Georgeff Road agreed to purchase the piece of land in dispute from the owners of 19 Georgeff Road. This variance addressed the consequence of the Lot Line Adjustment. 1. After the purchase, for the property on 17 Georgeff Road, the Net Area considered by the City of Rolling Hills would change from 0.8054 acres to 0.847 acres For the property on 19 Georgeff Road, the Net Area (Rolling Hills) would change from 0.868 acres to 0.810 acres. 2. After the purchase, for the property on 17 Georgeff Road, the front lot width would change from 150 feet to 160 feet. For the property on 19 Georgeff Road, the front width would change from 120 feet to 110 feet. 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 The adjusting of the lot line to the swale makes topographic sense resulting in the owners of 17 Georgeff Road owning the piece of land in dispute, thereby giving them the complete responsibility to maintain the integrity of the entire hillside. The paddock area downhill has subsided before. There is a safety concern here The change only involves lot line adjustment. There is no physical change whatsoever. This is not a new construction. The lots and the houses were of the exactdimensions and locations since the original subdivision and construction. The originall under the lot size requirement since the beginning. The original lot width of 19 Georgeff was also under the width requirement. FILING FEE A filing fee must accompany the application. Make check payable to: CITY OF ROLLING HILLS. A4'nsters/Fornrs/Variance- Rev.2006 • • OWNER'S DECLARATION I (We) declare under penalty ofr Iperjury that the foregoing is true and correct. Executed at (�-4Imo' ( this < day of By: By: e i 17 ci2 �L Address City . California, ,20S- 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: DATE FILED REPRESENTATIVE: FEE: COMPANY NAME: RECEIPT NO: COMPANY ADDRESS: BY: ZONING CASE NO TENTATIVE HEARING DATE: COMPANY PHONE NO. ( PROJECT ADDRESS: 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 day of By: By: (7 Address City d (4— , California 20 . CITY OF ROLLING HILLS ZONING CASE CERTIFIED PROPERTY OWNER'S LIST AFFIDAVIT STATE OF CALIFORNIA COUNTY OF LOS ANGELES CITY OF ROLLING HILLS §§ , declare under penalty of perjury that the attached list contains the names and addresses of all persons to whom all property is assessed as they appear on the latest available assessment roll of the County within the area described and for a distance of one thousand (1,000) feet from the exterior boundaries of property legally described as: Executed at this /1-6 day of Signatur , California, ,20 GcF • • City 0/ JUL INCORPORATED JANUARY 24, 1957 LOT LINE ADJUSTMENT APPLICATION ZONING CASE NO. The following information is necessary for the review of ALL applications. delay action. Attach extra sheets if necessary. RECORD OWNER(S): APPLICANT: 7� J' Cc_ yt,t.. w ebb Name Name �1 � R-� �I Address U Address 12 H- City CIOIW Zip (3►0)s4-i.fa Phone C1r City c oz7 ( Zip Phone (Attach a separate sheet if necessary, including names and addresses directors of corporations.) CONSENT: SIGNED (Prop SIGNED NO. 2 PORTUGUESE BEND ROAD ROLLING HILLS, CALIF. 90274 (310) 377.1521 FAX: (310) 377-7288 E-mail: cityofrh@aol.com Failure to furnish information will Name Address City Zip APPLICANT'S AGENT: (Engineer, Licensed Surveyor, Other) ( ) Phone of members of partnerships, joint ventures and I consent to the submission of the application accompanying this request. / ��� DATE l erty CERTIFICATION: SIGNED (Applicant or ' Agent) LEGAL DESCRIPTION: LOT NO. wner) 3( 7(0 F- DATE �/ (��� I hereby certify under penalty of perjury that the information herein provided is correct to the best of my knowledge. Lv ASSESSOR'S BOOK NO 7 S 6 7 PAGE D ( CITY OF ROLLING HILLS LOCATION: t i� d I Street addre or d t �ce from nearest cross str Between: C- ( (, cLo and DATE: 5/ 7 /O f PARCEL N o — 007 ,eo -f Z "--at • • In Land Use Zone General Plan Category Present Use of Site 1R-2S► j Proposed Use of Parcel(s) shown on Tentative Map S' Gcln4_ Surrounding Zoning: North South East West Domestic Water Source District Method of Sewage Disposal _� _ f -L— District LEGAL DESCRIPTION (All ownership comprising the proposed lot(s)/project.) If petitioning for a zone change, attach legal description of exterior boundaries of area subject to change: LOT LINE ADJUSTMENT: 1. Lots Existing (Gross each): 2. Total Gross Acres: / o — I — ft) ; fi Z — C 1- 7, zc �t tr) /•/2 1 ase...".e_ /• 0 ce S ACC 3. Lots Proposed: (Gross & Net each) 4f j — (4 .', 3/ sr Z ( 9 a_ .7 t C`) 4. Grading of Lot(s) by Applicant? YES NO 1/ (Show necessary grading design on site plan or tentative map. All grading must be balanced cut/fill.) Amount Cut i Amount Fill (.0 I- ) 5. Pad sizes for each lot: f 1 ( 1 f — 9 rek 7 rq ? ..so/ su — 6. Area of disturbance on each lot: (Square Feet) Percentage of net lot (40% Maximum • OWNER'S DECLARATION I (We) declare under penalty of perjury that the foregoing is true and correct. Executed at this day of�L cL By: By: 17 Address(1 le-t2A-rf6 0 U , California, , 20 ° 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: Cc REPRESENTATIVE: COMPANY NAME: COMPANY ADDRESS: COMPANY PHONE NO. ( 1 PROJECT ADDRESS: 17 it !Rd /9 `'6\ATO /Zd • DATE FILED FEE: RECEIPT NO: BY: ZONING CASE NO: TENTATIVE HEARING DATE: • • • CITY OF ROLLING HILLS ZONING CASE CERTIFIED PROPERTY OWNER'S LIST AFFIDAVIT STATE OF CALIFORNIA ) COUNTY OF LOS ANGELES ) ss CITY OF ROLLING HILLS ) , declare under penalty of perjury that the attached list contains the names and addresses of all persons to whom all property is assessed as they appear on the latest available assessment roll of the County within the area described and for a distance of one thousand (1,000) feet from the exterior boundaries of property legally described as: Executed at /l H ( l S day of--�- , California, this , 20 0 SIGN�ATURF ,/ 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 I D day of , California , 20 By: r 7q-(-.A!cace6 , ,e tl-, �o 2 7 F- �� (q _ RoL7¢- City • DATE ZONING CASE NO. ADDRESS _LC( cf6 ALL STRUCTURES MUST BE SHOWN ON THE PLAN CALCULATION OF LOT COVERAGE AREA AND STRUCTURES EXISTING NET LOT AREA RESIDENCE GARAGE 3o x 25 SWIMMING POOL/SPA<°tIDJ x t Zqa POOL EQUIPMENT GUEST HOUSE CABANA STABLE (dirt volume to be included in grading quantities) RECREATION COURT ATTACHED COVERED PORCHES ENTRYWAY/ PORTE COCHERE, BREEZEWAYS 3 7 & ( sq.ft. 3 5 So sq.ft. 750 sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. ATTACHED TRELLISES *DETACHED STRUCTURES: (circle all that applies) SHEDS, TRELLISES, GAZEBO, BARBECUE, OUTDOOR KITCHEN, ROOFED PLAY EQUP.- over 15 ft. high and over I20 sq. ft. in area, WATER FEATURES, ETC. SERVICE YARD � ( OTHER BASEMENT AREA (volume to be included in grading quantities) DEPTH OF BASEMENT TOTAL STRUCTURES % STRUCTURAL COVERAGE sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. et 0 sq.ft. sq.ft. sq.ft. TOTAL STRUCTURES EXCLUDING UP TO 5 & UP TO 69B.sq. ft. detached structures that are not higher than 10 ft. sq.ft. % STRUCTURAL COVERAGE 11.6 PROPOSED -3.5, z 7 sq.ft. sq.ft. sq.ft. sq. ft. sq. ft. sq.ft. sq_ft. (1( ) sq. f sq.ft. sq.ft. sq_ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. JJ sq.ft. 13."% % 43 ` 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. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. ";. %J sq.ft. sq.ft. ALL FLATWORK MUST BE SHOWN ON THE PLAN PRIMARY DRIVEWAY(S) PAVED WALKS, PATIO AREAS, COURTYARDS POOL DECKING OTHER PAVED DRIVEWAYS, ROAD EASEMENTS, PARKING PADS TOTAL FLATWORK % TOTAL FLATWORK COVERAGE TOTAL STRUCTURAL & FLATWORK COVERAGE % TOTAL COVERAGE TOTAL STRUCTURAL & FLATWORK COVERAGE Excl. the allowance of up to 5 —goo sq. ft. structures from previous page. % TOTAL COVERAGE z2- sq.ft. sq.ft. sq. ft. sq.ft. G037- sq.ft. i3.5 % 5 Q z sq.ft. sq.ft. 240 sq.ft. (33 sq.ft. sq.ft. % sq.ft. 7 7 sq.ft. 26.) % ZQ' % 5033t4396 ‘k5 74 - sq.ft. /61,3 sq.ft. sq.ft. sq.ft. sq.ft. sq. ft. sq.ft. % 35 a7 2C 7 % TOTAL DISTURBED AREA sq.ft. sq.ft. % DISTURBED AREA GRADING QUANTITY (include future stable, corral and access way; basement and all other areas to be graded) sq.ft. sq.ft. cubic yards 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 exceeds100 sq. ft., or if there are more than 5 such structures on the property. fil DATE PAI) NO. 1 • Z.C. NO. ADDRESS CALCULATION OF BUILDING PAD COVERAGE BUILDABLE PAD AREA EXISTING PROPOSED AND STRUCTURES BUILDING PAD RESIDENCE GARAGE POOL/SPA POOL EQUIPMENT CABANA/REC.RM GUEST HOUSE STABLE SPORTS COURT SERVICE YARD ATTACHED COVERED PORCHES Primary residence Accessory structures 901 sq.ft. 3 55 ° sq.ft. � 5° sq.fr. 1- 5 i sq.ft. sq.fr. sq.fr. sq.ft. sq.fr. sq.ft. 6sq.ft. AREA OF ATTACHED COVERED 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 1'` page not including allowed deductions) OTHER cq.ft. sq.ft. sq.ft. sq.ft. sq.fr. sq.fr. sq.ft. sq.ft. TOTAL STRUCTURES ON PAD NO. 1 4 S5.5 sq.ft. % BUILDING PAD COVERAGE TOTAL STRUCTURES ON PAD NO. I + 85 5 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 4% U1 sq.fr. 9°sq.ft. -15° sq.ft. L sq ft sq.ft. sq.ft. sq.ft. sq.ft. sq_ft. ( <q.ft. sq.ft. q. ft. sq.ft. sq. ft. sq. ft. q.ft. sq.fr. sq.ft. ✓ sq:fr. �PSSsq.ft. 4_ob sq.ft. sq.fr. sq.ft. sq.ft. ,sq.ft. sq.ft. sq.ft. sq.ft. sq.ft. sq.fr. sq.ft. sq.fr. sq.ft. .q.ft. sq.ft. sq.ft. cq.ft. cq.ft. cq.ft. 4o • � og DATE 3 ` ] Z.C. NO. ADDRESS 11 I CALCULATION OF BUILDING PAD COVERAGE I'APf NO. 2 BUILDABLE PAD AREA EXISTING PROPOSED AND STRUCTURES BUILDING PAD sq.ft. sq.fr. cq.ft. RESIDENCE sq.fr. sq.ft. sq.ft. GARAGE sq.ft. sq.ft. sq.ft. POOL/SPA sq.ft. sq.ft. sq.fr. POOL EQUIPMENT sq.ft. sq.ft. sq.ft. CABANA/REC.RM sq.ft. sq.ft. sq.fr. GUEST HOUSE cq.ft. sq.ft. sq.ft. STABLE sq.ft. sq.ft. sq.ft. SPORTS COURT sq.ft. sq.ft. sq.fr. SERVICE YARD sq.ft. sq.ft. sg5t. ATTACHED COVERED PORCHES Primary residence sq.ft. sq.ft. sq.ft. Accessory structures sq.ft. sq.ft. sq.ft. AREA OF ATTACHED COVERED sq.ft. sq.ft. sq.ft. PORCHES THAT EXCEED 10% OF THE SIZE OF RESIDENCE/ACCS. STRUCTURE ENTRYWAY/PORTE COCHERE/ BREEZEWAY sq.ft. sq.ft. sq.ft. ATTACHED TRELLISES sq.fr. sq.ft. sq.ft. ALL DETACHED STRUCTURES (from 1" page) sq.ft. sq.ft. sq.ft. ALL DETACHED STRUCTURES (from I" page not including allowed sq.ft. sq.ft. cq.ft. deductions) OTHER sq.ft. sq.ft. sq.ft. TOTAL STRUCTURES ON PAD NO. 2 sq.fr. sq.ft. sq.ft. % BUILDING PAD COVERAGE % °!o To TOTAL STRUCTURES ON PAD NO. 2 sq.ft. cq.ft. cq.ft. Nor incl. attached trellises, Not incl. allowed deductions, and incl. the area of covered porches that exceed 10% of the size of the residence/accs. structures. % BUILDING PAD COVERAGE DATE • Z.C. NO. ADDRESS qe-'9 • t t.i "iu0u. CALCULATION OF BUILDING PAD COVERAGE PAD NO. I No 'i ~- BUILDABLE PAD AREA EXISTING ROPCEDt AND STRUCTURES --thy Fir K BUILDING PAD L.(/ 0 ' ( sq ft. 11 / 161 sq.fr. cq.ft. RESIDENCE 4,670 sq ft ` -'47' sq.ft. sq.ft. GARAGE 50 ° sq.ft. Soo sq.ft. sq.ft. POOL/SPA 57 5 sq.ft. 56 sq.ft. sq.ft. POOL EQUIPMENT 6 5 sq.ft. C 3 sq.ft. sq.ft. CABANA/REC.RM sq.ft. sq.ft. sq.ft. GUEST HOUSE sq.ft. sq.ft. sq.ft. STABLE sq.fr. sq.ft. sq.fr. SPORTS COURT sq.ft. sq.ft. sq.ft. SERVICE YARD 12.O sq.ft. 1 10 sq.ft. sq.ft. ATTACHED COVERED PORCHES Primary residence sq.ft. sq.ft. 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 sq.ft. sq.ft. sq.ft. ATTACHED TRELLISES stilt. sq.fr. sq.ft. ALL DETACHED STRUCTURES stilt. sq.ft. sq.ft. (from 1' page) ALL DETACHED STRUCTURES sq.ft. sq.fr. sq.ft. (from I' page not including allowed deductions) OTHER sq.fr. sq.ft. , sq.ft. TOTAL STRUCTURES ON PAD NO. 1 7 7l cq.ft. % BUILDING PAD COVERAGE /53 TOTAL STRUCTURES ON PAD NO. 1 5 s76 Not incl. attached trellises, Not incl. allowed deductions, and incl. the area of covered porches that exceed 10% of the size of the residence/acts. structures. % BUILDING PAD COVERAGE Sg7 4'q.ft. sq.ft. 2,{0 9.71,sq.ft. sq.ft. 53 % fro Z ALL FLATWORK MUST BE SHOWN ON THE PLAN -PlUy p ° 44` • PRIMARY DRIVEWAY(S) 7O0 sq.ft. sq.ft. sq.ft. PAVED WALKS, PATIO aso ao. AREAS, COURTYARDS , (Do sq.ft. sq.ft. sq.ft. POOL DECKING -141 S sq.ft. sq.ft. sq.ft. OTHER PAVED DRIVEWAYS, ROAD EASEMENTS, PARKING PADS sq.ft. -±- f n o sq.ft_ sq. ft. TOTAL FLATWORK 4 3�5 sq.ft. op sq.ft. 4-¢ 2 5 sq.ft. % TOTAL FLATWORK COVERAGE i .3 % D. ZG % 12 • t, % TOTAL STRUCTURAL & FLATWORK COVERAGE TOTAL COVERAGE 35, 34 C t' 36 t 431.5) 1 I. 041 sq.ft. .�j % \r f: 36'1t 3 -1- sq.ft. sq.ft. % 30, Z % rj/i6 ? 43z5 r t TOTAL STRUCTURAL & 7g `I t. FLATWORK COVERAGE 1 D.Z4 I sq.ft. 1- (00 sq.ft. 1 tv34f sq.ft. Excl. the allowance of up to 5 -goo sq. ft. structures from previous page. TOTAL COVERAGE I % % ZS- % TOTAL DISTURBED AREA sq.ft. sq.ft. sq.ft. % DISTURBED AREA % % % GRADING QUANTITY (include future stable, corral and access way; basement and all other areas to be graded) cubic yards 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/OO sq. ft., or if there are more than 5 such structures on the property. DATE 3/1(0 ZONING CASE NO. ADDRESS 17 ALL STRUCTURES MUST BE SHOWN ON THE PLAN CALCULATION OF LOT COVERAGE AREA AND STRUCTURES EXISTING PROPOSED TO P NM. NET LOT AREA 35 .° 84- sq.ft. 3 6 , 'j 13 sq.ft. sq.ft. RESIDENCE 4 670 sq.ft. sq.ft. sq.ft. GARAGE so o sq.ft. sq.ft. sq.ft. SWIMMING POOL/SPA a sz-S sq.ft. sq.ft. sq.ft. POOL EQUIPMENT 63 sq.ft. sq.ft. sq.ft. GUEST HOUSE // sq.ft. sq.ft. sq.ft. CABANA " sq.ft. sq.ft. sq.ft. STABLE (dirt volume to be included in grading quantities) D EQ-o sq.ft. sq.ft. sq.ft. RECREATION COURT / sq.ft. sq.ft. sq.ft. ATTACHED COVERED PORCHES '� sq.ft. sq.ft. sq.ft. ENTRYWAY/ PORTECOCHERE, BREEZEWAYS sq.ft. sq.ft. sq.ft. ATTACHED TRELLISES sq.ft. sq.ft. sq.ft. *DETACHED STRUCTURES: (circle all that applies) SHEDS, TRELLISES, GAZEBO, sq.ft. sq.ft. sq.ft. BARBECUE, OUTDOOR KITCHEN, sq.ft. sq.ft. sq.ft. ROOFED PLAY EQUP.- over 15 ft. sq.ft. sq.ft. sq.ft. high and over 120 sq. ft. in area, WATER FEATURES, ETC. 31 e- sq.ft. sq.ft. sq.ft. SERVICE YARD D I W sq.ft. sq.ft. sq.ft. OTHER sq.ft. sq.ft. sq.ft. BASEMENT AREA / sq.ft. sq.ft. sq.ft. (volume to be included in grading quantities) DEPTH OF BASEMENT TOTAL STRUCTURES 6134 sq.ft. 6, ? 3 L sq.ft. sq.ft. % STRUCTURAL COVERAGE I 1 '1 % % TOTAL STRUCTURES EXCLUDING UP TO 5 & •UP TO goo Cresasq. ft. detached structures that are not higher than '10 ft. % STRUCTURAL COVERAGE 5136 sq.ft. Sq 3 6 sq.ft. (-7 % % sq.ft. Flo • • DATE I'AD 'O.2 Z.C. NO. ADDRESS CALCULATION OF BUILDING PAD COVERAGE BUILDABLE PAD AREA AND STRUCTURES EXISTING PROPOSED Tye #1/4- BUILDING PAD sl.ft. sq.ft. sq.ft. RESIDENCE sq.ft. sq.ft. sq.ft. GARAGE sq.ft. sq.ft. sq.ft. POOIJSPA sq.ft. sq.ft. sq.fr. POOL EQUIPMENT sq.ft. sq.ft. sq.ft. CABANA/REC.RM sq.ft. sq.ft. sq.ft. GUEST HOUSE sq.ft. sq.ft. sq.ft. STABLE sq.ft. sq.ft. sq.ft. SPORTS COURT sq.ft. sq.ft. sq.ft. SERVICE YARD si.ft. sq.ft, sq.fr. ATTACHED COVERED PORCHES Primary residence sift. sq.ft. 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 sq.ft. sq.fr. sq.ft. ATTACHED TRELLISES sq.ft. sq.ft. sq.ft. ALL DETACHED STRUCTURES (from 1" page) sq.ft. sq.ft. sq.ft. ALL DETACHED STRUCTURES (from 1 page not including allowed sq.ft. sq.ft. sq.ft. deductions) OTHER sq.ft. sq.ft. sq.ft. TOTAL STRUCTURES ON PAD NO. 2 q.ft. sq.ft. sq.ft. % BUILDING PAD COVERAGE % % % TOTAL STRUCTURES ON PAD NO. 2 sq.ft. sq.fr. sq.ft. Not incl. attached trellises, Nor incl. allowed deductions, and incl. the area of covered porches that exceed l0% of the size of the residence/accs. structures. % BUILDING PAD COVERAGE • • City ofiellinl 31,14 INCORPORATED JANUARY 24, 1957 ENVIRONMENTAL INFORMATION FORM (To Be Completed By Applicant) Date Filed ✓r %°(° Zoning Case No. GENERAL INFORMATION 1. Applicant(s) Cc-- 'h- • Address 2. Legal Owner(s) Cc_ y - l 1 cT-v-1-1r-q 12-d. i W Q�/ C Tel. ( NO. 2 PORTUGUESE BEND ROAD ROLLING HILLS, CALIF. 90274 (310) 377-1521 FAX: (310) 377-7288 E-mail: cityofrh@aol.com Tel. ('7() )S¢(• /Zb e Address 1 tin I a �,�,� UUV ✓L Ul-6 3. Project Address f 1 / ( 1 q*---0/1-16 Assessor's Book No. 1 S 6 7 - b (S - o (O . 12c1 Lot No. 6 4. Other related permits and other public approvals required for this project, including those required by city, regional, state and federal agencies: 5. Existing zoning district R- 6. Proposed project/use of site t - Q., a cQy, w,-..T. .mat 9 A- -e,x t ST'_. c _ j Qo-t Z (t 7 61 l CO 4e t PROJECT DESCRIPTION U� (o 0 $ `� f� <� Ulu) •� "3��) Q �— 7. Site size I-1i265 # —� 41, go4- ¢g,9SS s7..1----- fit" 4/,3fh s?. .Q L 3?n$g"q --> a6f913st 1 371g3I sA ---- 35.zs7 s‘ 8. Net lot area " et Lot Area" means the otal 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." 9. Total square footage of structures d 1't-e 7 O s 6 10. Number of floors of construction 11. Basement square footage I-1 February 2002 Environmental Information Form ®Printed on Recycled P:gx:r • Ill 1 J ioo , I1,14 (50-- 12. Total combined flatwork and structural lot coverage 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? 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? 10 b. (Second driveway requires approved Conditional Use Permit from Planning Commission). (0 t c. Width of driveway(s) Existing? (eit Zto � Pr osed? (Maximum of 20 foot width unless approved by the P anning 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? N (Requires Traffic Commission Review). Number of driveway(s) Existing? 1 \"' "' \ Proposed? Proposed? e. Grade of driveway(s)? Existing? 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 Does driveway cover more than a maximum 20% of the area of the yard in which it is located? NI Explain h. Does uncovered parking a,re� cover more than a maximum 10% of the area of the yard in which it is located? N Explain Does vehicul r accessway to stable and corral have a maximum slope of 25% or less? N Stable and corral average vehicular access slope j. Does property have an above ground garage with a minimum capacity of 2 cars? With guest house a minimum of 3 cars? 18. Grading quantities shall be balanced. Amount cut N 1� Amount fill (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 20. If residential, include the unit size. Square feet q 4D7° Sq %r g. 1-2 3 S S o 5`J( February 2002 Environmental Information Form • • • 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. Nfr 22. If industrial, indicate the type of project, estimated employment per shift, and loading facilities. Ntr 23. If institutional, indicate the major function, estimated employment per shift, estimated occupancy, loading facilities, and community benefits to be derived from the project. N� 24. Attach plans. 25. Proposed scheduling. 26. If the project involves a site plan review, variance, conditional use or rezoning application, state this and indicate clearly why the application is required. VaAA. tt..,( AO (a/1ne3E CtIvt-oUr-e.4 , J- ,.,Jo( lio 4410"1 V ,D ,il. z s- fib, axf�l �f ' C!✓. s — .ems bw 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. /Jilt 1-3 February 2002 Environmental Information Form • • 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. J Ct (18aA,-;. 49-C 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 1-4 Yes No WA ✓ _ V _ 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 • • EVALUATION OF ENVIRONMENTAL IMPACTS: 1. A brief explanation is required for all answers except "No Impact" answers that are adequately supported by the information sources a lead agency cites in the parentheses following each question. A "No Impact" answer is adequately supported if the referenced information sources show that the impact simply does not apply to projects like the one involved (e.g. the project falls outside a fault rupture zone). A "No Impact" answer should be explained where it is based on project -specific factors as well as general standards (e.g. the project will not expose sensitive receptors to pollutants, based on a project -specific screening analysis). 2. All answers must take account of the whole action involved, including off -site as well as on -site, cumulative as well as project -level, indirect as well as direct, and construction as well as operational impacts. 3. Once the Lead Agency has determined that a particular physical impact may occur, then the checklist answers must indicate whether the impact is potentially significant, less than significant with mitigation, or less than significant. "Potentially Significant Impact" is appropriate if there is substantial evidence that an effect may be significant. ff there are one or more "Potentially Significant Impact" entries when the determination is made, an EIR is required. 4. "Negative Declaration: Less Than Significant With Mitigation Incorporated" applies where the incorporation of mitigation measures has reduced an effect from "Potentially Significant Impact" to a "Less Than Significant Impact." The Lead Agency must describe the mitigation measures, and briefly explain how they reduce the effect to a less than significant level (mitigation measures from Section XVII, "Earlier Analyses," above may be cross-referenced). 5. Earlier analyses may be used where, pursuant to the tiering, program EIR, or other CEQA process, an effect has been adequately analyzed in an earlier EIR or negative declaration. See State CEQA Guidelines Section 15063(c)(3)(D). In this case, a brief discussion should identify the following: a. Earlier Analysis Used. Identify and state where they are available for review. b. Impacts Adequately Addressed. Identify which effects from the above checklist were within the scope of and adequately analyzed in an earlier document pursuant to applicable legal standards, and state whether such effects were addressed by mitigation measures based on the earlier analysis. c. Mitigation Measures. For effects that are "Less Than Significant With Mitigation Measures Incorporated," describe the mitigation measures which were incorporated or refined from the earlier document and the extent to which they address site -specific conditions for the project. 6. Lead agencies are encouraged to incorporate into the checklist references to information sources for potential impacts (e.g., general plans, zoning ordinances). Reference to a previously prepared or outside document should, where appropriate, include a reference to the page or pages where the statement is substantiated. 7. Supporting Information Sources: A source list should be attached, and other sources used or individuals contacted should be cited in the discussion. 8. This is only a suggested form, and lead agencies are free to use different formats; however, lead agencies should normally address the questions from this checklist that are relevant to a project's environmental effects in whatever format is selected. 9. The explanation of each issue should identify: a. the significance criteria or threshold, if any, used to evaluate each question; and b. the mitigation measure identified, if any, to reduce the impact to less than significance. February 2002 Environmental Information Form 1-5 • • Issues: I. AESTHETICS— Would the project: a) Have a substantial adverse effect on a scenic vista? b) Substantially damage scenic resources, including but not limited to, trees, rock outcroppings, and historic buildings within a state scenic highway? c) Substantially degrade the existing visual character or quality of the site and its surroundings? d) Create a new source of substantial light or glare which would adversely affect day or nighttime views in the area? II. AGRICULTURE RESOURCES: In determining whether impacts to agricultural 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 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 Williamson Act contract? c) Involve other changes in the existing environment 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? Potentially Significant Impact Less Than Significant With Mitigation Incorporation Less Than Significant No Impact Impact ❑ 0 0 ❑ 0 0 C ❑ ❑ ❑ cl ❑ ❑ 0 e% ❑ 0 ❑ C' o ❑ 0 lc' ❑ 0 0 (I' ❑ 0 0 (e5 ❑ 0 0 �O February 2002 Environmental Information Form 1-6 Less Than Potentially Significant With Less Than Significant Mitigation Significant No Impact Incorporation Impact Impact b) Violate any air quality standard or contribute 0 0 0 1E1 substantially to an existing or projected air quality violation? c) Result in a cumulatively considerable net increase of 0 0 0 lY3 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 concentrations? e) Create objectionable odors affecting a substantial number of people? ❑ ❑ ❑ CI' ❑ ❑ ❑ IV. BIOLOGICAL RESOURCES — Would the project: a) Have a substantial adverse effect, either directly or 0 ❑ 0 [Id 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 IS" 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 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 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 biological resources, such as a tree preservation policy or ordinance? f) Conflict with the provisions of an adopted Habitat 0 0 0 J2( Conservation Plan, Natural Community Conservation Plan, or other approved local, regional, or state habitat conservation plan? February 2002 Environmental Information Form 1-7 • f • Less • Potentially Significant ith 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 0 0 le 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 If1 significance of an archaeological resource pursuant to §15064.5 of the State CEQA Guidelines? c) Directly or indirectly destroy a unique paleontological 0 0 0 VII resource or site or unique geologic feature? • d) Disturb any human remains, including those interred 0 0 0 L( outside of formal cemeteries? V1. GEOLOGY AND SOILS— Would the project: a) Expose people or structures to potential substantial adverse effects, including the risk of loss, injury, or death involving: i) Rupture of a known earthquake fault, as delineated 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. ,or r%o- Po s qj 0 ""`s Li) 'l+ s �L pnzwpts4 la-tffe, ❑ ❑ ❑ ii) Strong seismic ground shaking? 0 0 0 Br iii) Seismic -related ground failure, including 0 0 0 l liquefaction? iv) Landslides? 0 0 0 li b) Result in substantial soil erosion or the Toss of topsoil? 0 0 0 V c). Be located on a geologic unit or soil that is unstable, 0 0 0 61 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 0 0 Of 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 0 use of septic tanks or alternative waste water disposal systems where sewers are not available for the disposal of waste water? February 2002 Environmental Information Form 1-8 • • Less n Potentially Significant With Less Than Significant Mitigation Significant No Impact Incorporation Impact Impact VII. HAZARDS AND HAZARDOUS MATERIALS — Would the project: a) Create a significant hazard to the public or the ❑ 0 ❑ environment through the routine transport, use, or disposal of hazardous materials? b) Create a significant hazard to the public or the 0 0 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 0 CF 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 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 0 0 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, 0 0 0 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 0 0 0 adopted emergency response plan or emergency evacuation plan? h) Expose people or structures to a significant risk of 0 0 0 Toss, injury or death involving wildland fires, including where wildlands are adjacent to urbanized areas or where residences are intermixed with wildlands? February 2002 Environmental Information Form I-9 • • Less Potentially Significant With Less Than Significant Mitigation Significant No Impact Incorporation Impact Impact VIII. HYDROLOGY AND WATER QUALITY — Would the project: a) Violate any water quality standards or waste discharge 0 0 0 requirements? b) Substantially deplete groundwater supplies or 0 0 0 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 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 ❑ ❑ 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 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 tej g) Place housing within a 100-year flood hazard area as ❑ ❑ 0 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 0 ❑ 0 which would impede or redirect flood flows? i) Expose people or structures to a significant risk of loss, 0 0 0 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? El 0 ta February 2002 Environmental Information Form 1-10 • • Potentially Signifsscant With • Less Than Significant Miti ation Significant No Impact incorporation Impact Impact IX. LAND USE AND PLANNING — Would the project: a) Physically divide an established community? 0 0 0 0 b) Conflict with any applicable land use plan, policy, or 0 0 ❑ 0 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 0 ❑ 0 0 natural community conservation plan? X. MINERAL RESOURCES — Would the project: a) Result in the loss of availability of a known mineral 0 0 0 0 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 0 0 0 0 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 0 ❑ ❑ 0 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 0 0 0 ❑ groundborne vibration or groundborne noise levels? c) A substantial permanent increase in ambient noise 0 0 0 0 levels in the project vicinity above levels existing without the project? d) A substantial temporary or periodic increase in ambient ❑ 0 0 0 noise levels in the project vicinity above levels existing without the project? e) For a project located within an airport land use plan or, 0 ❑ 0 0 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 0 0 0 ❑ the project expose people residing or working in the project area to excessive noise levels? February 2002 Environmental Information Form • • Less Potentially Significant Vieth Less Than Significant Mitigation Significant No Impact Incorporation Impact Impact XII. POPULATION AND HOUSING— Would the project: a) Induce substantial population growth in an area, either 0 0 0 bi 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 CI If/ 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 id Police protection? 0 0 0 p/ Schools? 0 0 0 Parks? 0 ❑ 0 kci/ Other public facilities? 0 0 0 Pi/ XIV. RECREATION a) Would the project increase the use of existing 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 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 XV. TRANSPORTATION/TRAFFIC — Would the project: a) Cause an increase in traffic which is substantial in relation to the existing traffic load 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 service standard established by the county congestion management agency for designated roads or highways? c) Result in achange in air traffic patterns, including either._ an increase in traffic levels or a change, in location that results in substantial safety risks? ) Substantially increase hazards due to a design feature (e.g., sharp curves or dangerous intersections) or incompatible uses (e.g., farm equipment)? e) Result in inadequate emergency access? f) Result in inadequate parking capacity? g) Conflict with adopted policies, plans, or programs supporting alternative transportation (e.g., but turnouts, bicycle racks)? XVI. UTILITIES AND SERVICE SYSTEMS — Would the project: a) Exceed wastewater treatment requirements of the applicable Regional Water Control Board? b) Require or result in the construction of new water or 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 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 project from existing entitlements and resources, or are new or expanded entitlements needed? Potentially Significant Impact El Less Than Significant With Mitigation Incorporation 0 Less Than Significant Impact No Impact `❑ ❑ ❑ ❑(-Le ❑ ❑ ❑ ❑ 0 0 ❑ 0 0 ❑ 0 0 ❑ 0 0 ❑ ❑ 0 ❑ 0 0 0 0 El El 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: 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 Less Than Significant With Mitigation Incorporation 0 Less Than Significant Impact 0 ❑ ❑ 0 ❑ 0 0 ❑ 0 0 ❑ 0 0 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ No Impact co) February 2002 Environmental Information Form 1-14 • • XVIII. MANDATORY FINDINGS OF SIGNIFICANCE 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 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 will cause substantial adverse effects on human beings, either directly or indirectly? Potentially Significant Impact Less Than Significant With Mitigation Incorporation Less Than Significant No Impact Impact ❑ ❑ ❑ ll( ❑ ❑ February 2002 Environmental Information Form 1-15 • • 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 op 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: 2. Address: ( 3. Phone Number: 4. {Q.� tz_4 CA- ?oZ79- Address of Site (street name and number if available, and ZIP code): 1/6 I. 5. Local Agency (city/c unty): 6. Assessor's book, page, and parcel number: I 76s 1011-1,Q__ (16 7567-oi s- v(v 7. Specify any list pursuant to Section 65962.5 of the Government Code: STATE 0 F CALIFORNIA HAZARDOUS WASTE AND SUBSTANCES SITES LIST (available at Citv Hall). 8. Regulatory identification number: 9. Date of List: JULY 1992 Date 3/(b For Signature Applicant 1-16 February 2002 Environmental Information Form • 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. 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 For Signature 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 Signature Applicant 1-17 February 2002 Environmental Information Form