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490, An addition to SFR 925 SF to e, ApplicationRi' t1EST FOR NEARING FOR ZONE VARIANCE CITY OF ROLLING NILLS The undersigned � �- IAA 18S ' t1k- L&J imua3k. Name I Bow Street Address (1) is/are the owner(s) or is/are in lawful possession of (2) bas permission of the owner Legal description of property situated at Lot Street Address 541 _32.5D Telephone Number 22150 Tract Describe in detail the nature of the proposed use, including what aspects of the . project require a Variance. *P--r) • Criteria to be satisfied for grant of 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. •- X LsiltUel P S c l E 13. .1 T 1)-(A ' L .B1- - As )4-W N1 t iij c9` J 12--S Such change will not be materially detrimental to the public welfare nor injurious to the property or imnr',vements in such vicinity and zone where property -is located because. Pas ( i 3 )4-L-414-M) u /LJ pz t/ A- 11 • FILING FEE 1► fllina foe. .a..of rr-r.eunnanv �{.. PROPERTY OWNER: OWNERS ADDRESS: TELEPHONE NO: PROPERTY ADDRESS: REQUEST FOR, HEARING 7OR SITE PLAN REVIEW CITY OF ROLLING HILLS l‘\g- - MR-5. 1-1A W.-AtN1 431.1- 12. #1 tt tzzAD 541 -3250 4 l SOW I E. I-- D LEGAL DESCRIPTION: LOT NO 15 -85 ASSESSORS BOOR NO 6013 PAGE_ PARCEL 75b7 -007 -O2J AGENT' 8 NAME: C.01). Flow , I ittC. AGENT'S ADDRESS: 2(p 141LL:G2• ar M.b4t oWS, ta)LLINHILLS Tig7 a TELEPHONE NO: (3 I P) 54-I , g49 O ****** *******************************sa**********************s****** NATURE OF PROPOSED PROJECT Describe in detail the nature of the proposed project, including what aspects of the project require a Site Plan Review: T(E 1 l2 p , t po-o-A c-oCD A Zo1,s7114(v � Q • FT. t D t g. 4-N. D A 4- 4.1=-T • CQA-P-/ fob. `Co W Fl• 1G 1.4 A 9 -5 SQ r=T• IIONb t PLAN N I� 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 with the General Plan, the Zoning Ordinance and surrounding uses? Explain how it compares to the sizes, setbacks and other characteristics of neighboring houses. T't J P 5 c OM, P AT1 ISLE. w / 'Ti3- Cod l�.l l✓ I2-A- L. P 1 A -No -2.c7 i I`► (v 042z4 del l`Ic.Z AN h `ram SURR..ouNJ 1I4 C� rt-tot-1-1 H-Geb , ALL. Simi t• )14 Atz.� Site Plan Review C StMtL(��" tz. A,I,�tt. Ap �-I1 1VI2-4L, Application STvl, L�. -9- ANL 5I 1M/ LIS- -T 5 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. E PhpP 5 yo4-NJ r1oNis {)t`) N.F)1' Ta.m VU1n31 ®• 21-A 1 U ® LSTiN (-� / -TV{ -t.._. �A-Thi s DP- Tt�1- E iT 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 rot modify existing drainage redirect drainage flow unless into an existing drainage course. Explain the nature and extent of the impact of grading and proposed minimization on lots. THA-b1 LTtoN.S No Nn 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. TH P12-m-p es n rn. nit rS n ' 11A.6\ /91(_ c�� �-�U f.� iU l`(I2 Ir, 1),Cr i z-noN. ALL 1 .ND1"-F (`?1J 4--L . C-SC- -P LNI,(P IA)LLL cemiq AT l l T E K IS N (0 Site Plan Review Application -10- 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. Explain how the lot coverage proposed compares with lot coverage square footage and percentages on neighboring lots. Tti<01= TRtfc17rUR- S PLUS PP 1&3 J) Ls 8,0 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. -j'H1 r 15crtl. D�.V, m fr T L A-n r iS FI- . m Ov\ L F U ( &) ► 1,- 3 ('lam 6 �CZ12,41 Imo) A- JL\ t p_12.n19 N 1» M. k? S b b ,e=Ls G. Is the site development plan sensitive and not detrimental to convenience and safety of circulation for pedestrians and vehicles? Explain how the number and types of vehicles relate to the driveway location, design, trip data, landscaping and other on -site parking or storage areas. s r D V(✓L 9P iVl �t� fiJ l r i 5 Art` ` IAA LiV L, 1T) 15 G t r i LA-Tt o1-! P LCt �?'1z/i4NS A-/ob �1 1GL>✓S. Site Plan Review Application -11- 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. �> PR-D-P66✓1) T t/ LDPM�NTr PLJ ZEDS I hereby certify that the statements furnished above, and in attached exhibits, presents the data and information required for the site plan review criteria evaluation to the best of my ability; and,.that the facts, statements and other information presented are true and correct to the best of my knowledge and belief. 11 Date: f I t (4 3 nti.C4.. signature For: Applicant Site Plan Review Application -12- OWNER' B DECLARATION I (We) declare under penalty of perjury that the foregoing is true and correct. Executed at ta©LLt 'Jl LL , California, this P day of f- , 19, 199A4,3 1 1��cc i . i-.c&A-N LL tiLfr 41 LLS (address) 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: C • Ut) • A) } 1NfJ DATE FILED ' ! (c 15- REPRESENTATIVE: (3.111.48 f FEE: 1,CD7) COMPANY NAME: RECEIPT NO: 6-30S COMPANY ADDRESS: 2-to 144 LLc-i-s7' BY: A ta MW,(40.)-fi t 1,1 N*, l LlS J~STj �5 ZONING CASE NO: 440 COMPANY PHONE NO. (3t 1 S40 - Bei'T TENTATIVE HEARING DATE: PROJECT ADDRESS: '16 I 1 iO Tl IZD . }'1-1 Ltrs Site Plan Review Application -13- 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 1.24M L..t W,-, aILLS , California this (p day of i , 191 //2 — By: By: Site Plan Review Application -14- A-N Address . .PICL,LA 14 t' 1 LLS 1 C City CITY OF ROLLING RILLS ZONING CASE CERTIFIED PROPERTY OWNER'S LIST AFFIDAVIT STATE OF CALIFORNIA COUNTY OF LOS ANGELES ) ss I, c. UJ. tAauff Hive. , 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 O L L. L I4 r, CH. L L 3 this (p Conditional Use, Permit Variance Site Plan Review Zone Change Site Plan Review Application -15- day , California, /1 iw , 19.11. s DATE 11495 ZONING CASE ND. ADDRESS k CIU I*- CZ.©Ac APPLICAN'^ C . LY. 1 E� I, NC. . CALCULATION OF BUILDING PAD COVERAGE PAD NO. 1 BUILDABLE PAD AREA 14151© sq.ft. RESIDENCE z92.5 sa.ft. GARAGE 4 (a2, sa.ft. STABLE (BARN) t 000 sq.ft. POOL sq.ft. RECREATION COURT TOTAL STRUCIURES ON PAD NO. 1 % BUILDING PAD COVERAGE sq.ft. 100 sq.ft. 4-457 sq.ft. 30.'1 % PAD NO. 2 BUILDABLE PAD AREA sq.ft. RESIDENCE sq.ft. GARAGE sa.ft. STABLE (BARN) sq.ft. POOL sq.ft. RECREATION COURT ( ) sq.ft. OTHER sq.ft. TOTAL STRUCI'URES ON PAD NO. 2 sq.ft. % BUILDING PAD COVERAGE -8- • DATE 714 (q5 ZONING CASE NO. ADDRESS 1 It APPLICANT c .1 k • nra> >=1 CALCULATION OF tar COVERAGE BUILDING AREAS EXISTING NET LOT AREA '34,o64sq. ft. BUILDING PAD(S) 1.579D sq.ft. RESIDENCE 2ocO sq.ft. GARAGE 4e/— sq.ft. SWD44ING POOL/SPA — sq.ft. STABLE I£O sq.ft. RECREATION COURT SERVICE YARD OTHIMI— SroR.Ac TOTAL STRUCTURES % STRUCTURAL COVE AGE % PAD COVERAGE DRIVZ4AY PAVED WALKS & PATIO AREAS POOL DECKING TOTAL FLATWO K % TOTAL FLATWORK COVERAGE TOTAL STRUCTURAL & FLAZWORK COVERAGE % TOTAL COVERAGE sq.ft. 100 sq.ft. 324 sq.ft. 3886 sq.ft. 114 % 24.3 % PROPOSED —' sq.ft. —' sq.ft. `f2.5 sq.ft. sq.ft. -' sq.ft. sq.ft. sq.ft. sq.ft. 324 sq.ft. TOTAL ? DG 4 sq.ft. 15ii90sq. ft. 2�z.5 sq.ft. 4 22. sq.ft. sq.ft. IGUD sq.ft,. sq.ft. 100 sq.ft. sq.ft. 44457 sq.ft. 28•D % 1121 sq.ft. sq.ft. 1127 sq.ft. 105D sq.ft. 45T7 sq.ft. 1 41'60 sq.ft. sq.ft. sq.ft. sq.ft. 2157 sq.ft. 415D sq.ft. 2-607 sq.ft. .3 % 1.9- % 7.7 % 47043 sq.ft. 11•1 % 1051 sq.ft. 3.1 % 7D94 sq.ft. 7D•8% DATE ZONING CASE ADDRESS APPLICANT btu I h4D c •\V, 140rue t . • CALCULATION OF BUILDING PA^ Ov"'r4z'='r PAD NO. 1 BUILDABLE PAD AREA l 5110 sq.ft. RESIDENCE 2925 sq.ft. GARAGE 4(2. sq.ft. STABLE (BARN) l D©D sq.ft. POOL sq.ft. RECREATION COURT sq.ft. IOC) sq.ft. TOR'AL sTRUCIVRES cti PAD NO. 1 4487 sq.ft. % BUILDING PAD COVERAGE 25. I % PAD NO. 2 BUILDABLE PAD AREA sq.ft. RESIDENCE sq.ft. GARAGE sq.ft. STABLE (BARN) sq.ft. POOL sq.ft. RECREATION COURT ( sq.ft. OTHER sq.ft. TOTAL STRUCTURES ON PAD NO. 2 % BUILDING PAD COVERAGE sq.ft. • • • C1iy ol RO//4 JUL INCORPORATED JANUARY 24, 1957 ENVIRONMENTAL INFORMATION FORM (To Be Completed By Applicant) Date Filed GENERAL INFORMATION NO. 2 PORTUGUESE BEND ROAD ROLLING HILLS. CALIF. 90274 (213) 377-1521 FAX: (213) 377-7288 Zoning Case No. 1. Applicant, address and telephone no. C.W. Haiti 2-Co fr ILL-612- " (MADQ\YS. 12cL-L!Nb NILL', 5TAT1= , (31o)54l-EiD 2. Legal Owner, address and telephone no. (if different from above) I\\P. 4- INA ri5 . L-}AP.LAN 81 T'TN EI'z , *I l bowl, 1 QA) NO) 541-2.540 3. Address of Assessor's Lot No. Project *I teNVIEL. r c t Book, Page, Parcel No. 75(0 1, p©7 --.p2 b I 4. List and describe any other related permits and other public approvals required for this project,including those required by city, regional, state and federal agencies: .OVt-l`ry gV 1I-_D)►'$ & PI✓Rl\\lT 5. Existing zoning district '12»As--1 6. Proposed use of site (project for which this form is filed): PROJECT DESCRIPTION 7. Site size 8. Net lot area 34 O(v4 P-T• 9. Total square footage of structures (XII.Mg ,) 24(02 sQ, fir. 10. Number of floors of construction -1- ON 1^. • • 11. Basement square footage N144. 12. Total combined flatwork and structural lot coverage 11.51,o 13. Will any exterior walls be removed or relocated? Which walls? `(E5 t Rt4,R 14. Will any interior walls be removed or relocated? Which walls? YES 1 AT T5E0 W901MS 15. Will the entire building structure require a new roof? klo 16. Will the existing roof remain intact, with less than 200 square feet added? No 17. Will cut and fill be balanced? Amount cut N•A• Amount fill 18. If residential, include the unit size, approximate sale price and household size expected. Nt.A. 19. 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. N.q, 20. If this is industrial project indicate the type of project, estimated employment per shift, and loading facilities. t't.A 21. If institutional, indicate the major function, estimated employment per shift, estimated occupancy, loading facilities, and community benefits to be derived from the project. N.A. 22. Attach plans. 23. Proposed scheduling. 24. If the project involves a variance, conditional use or rezoning application, state this and indicate clearly why the application is required. N.A. Are the following items applicable to the project or its effects? Discuss below all items checked yes (attach additional sheets as necessary). Yes No X 25. Change in existing features of any bays, tidelands, beaches, lakes or hills, or substantial alteration of ground contours. X 26. Change in scenic views or vistas from existing residential areas or public lands or roads. - 2- • • X 27. Change in pattern, scale or character of general area of project. 28. Significant amounts of solid waste or litter. 29. Change in dust, ash, smoke, fumes, or odors in vicinity. 30. Change in ocean, bay, lake, stream or ground water quality or quantity, or alteration of existing draining patterns. X 31. Substantial change in existing noise or vibration levels in the vicinity. 1_ 32. Site on filled land or on slope of 10 percent or more. 33. Use or disposal of potentially hazardous materials, such as toxic substances, flammable or explosives. 34. Substantial change in demand for municipal services (police, fire, water, sewage, etc.). 35. Substantially increased fossil fuel consumption (electricity, oil, natural gas, etc.). 36. Relationship to a larger project or series of projects. ENVIRONMENTAL SETTING 37. 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. 114i r x LS-1-► 4 Ca S 0 'I'l=. C. ON S L3Ts o f A S 1 , L E z p.h1 l L -ES t b L F)G,4-srp..D t.NL A l-.J1 . L PA.D . T N- LS AO vibENc . OF tADtL INISTA- It-t'14. • • 38. 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. 1141,9INt4 & Ak-E A- Z QN.L515T ct SLMILtiklz. 51 iv. cc, . ea. 176tM L L 11 Izt 1 b NJC.1~'S ENVIRONMENTAL IMPACTS (Please explain all "yes" and "maybe" answers on separate sheets.) 39. Earth. Will the proposal result in: a. Unstable earth conditions or in changes in geologic substructures? b. Disruptions, displacements, com- paction or overcovering of the soil? c. Change in topography or ground surface relief features? d. The destruction, covering or modification of any unique geologic or physical features? e. Any increase in wind or water erosion of soils, either on or off the site? YES MAYBE NO f. Changes in deposition or erosion of beach sands, or changes in siltation, deposition or erosion which may modify the channel of a river or stream or the bed of the ocean or any bay, inlet or lake? g. Exposure of people or property to geologic hazards such as earth- quakes, landslides, mudslides, ground failure, or similar hazards? -4- • • 40. Air. Will the proposal a. Substantial deterioration of result in: air emissions or ambient air qaulity? b. The creation of objectionable odors? c. Alteration of air movement, moisture or temperature, or any change in climate, either locally or regionally? 41. Water. Will the proposal result in: a. Changes in currents, or the course or direction of water move- ments, in either marine or fresh waters? b. Changes in absorption rates, drainage patterns, or the rate and amount of surface water runoff? c. Alterations to the course or flow of flood waters? d. Change in the amount of surface water in any water body? e. Discharge into surface waters, or in any alteration of surface water quality, including but not limited to temperature, dissolved oxygen or turbidity? f. Alteration of the direction or rate of flow of ground waters? g. Change in the quantity of ground waters, either through direct additions or withdrawals, or through interception of an aquifer by cuts or excavations? h. Substantial reduction in the amount of water otherwise available for public water supplies? i. Exposure of people or property to water -related hazards such as flooding or tidal waves? -5- YES MAYBE NO j. Significant changes in the temperature, flow, or chemical content of surface thermal springs? 42. Plant Life. Will the proposal result in: a. Change in the diversity of species, or number of any species of plants (including trees, shrubs, grass, crops, microflora and aquatic plants)? b. Reduction of the numbers of any unique, rare or endangered species of plants? c. Introduction of new species of plants into an area, or in a barrier to the normal replenishment of existing species? d. Reduction in acreage of any agricultural crop? 43. Animal Life. Will the proposal result in: a. Change in the diversity of species, or numbers of any species of animals (birds, land animals including reptiles, fish and shellfish, benthic organisms, insects or micro - fauna) ? b. Reduction of the numbers of any unique, rare or endangered species of animals? c. Introduction of new species of animals into an area, or result in a barrier to the migration or move- ment of animals? d. Deterioration to existing fish or wildlife habitat? 44. Noise. Will the proposal result in: a. Increases in existing noise levels? b. Exposure of people to severe noise levels? -6- YES MAYBE NO X X X X X 45. Lioht and glare. Will the proposal produce new light or glare? 46. Land Use. Will the proposal result in a substantial alteration of the present or planned land use of an area? 47. Natural Resources. Will the proposal result in: a. Increase in the rate of use of any natural resources? b. Substantial depletion of any nonrenewable natural resource? 48. Risk of Upset. Will the proposal involve: a. A risk of an explosion or the release of hazardous sustances (including, but not limited to, oil, pesticides, chemical or radiation) in the event of an accident or upset conditions? b. Possible interference with an emergency response plan or an emer-40 gency evacuation plan? 49. Population. Will the proposal alter the location, distribution, density, or growth rate of the human population of an area? 50. Housina. Will the proposal affect existing housing, or create a demand for additional housing? 51. Transportation/Circulation. Will the proposal result in: a. Generation of substantial additional vehicular movement? b. Effects on existing parking facilities, or demand for new parking? c. Substantial impact upon existing transportation systems? -7- YES MAYBE NO x • • d. Alterations to present patterns of circulation or movement of people and/or goods? e. Alterations to waterborne, rail or air traffic? Yes Maybe f. Increase in traffic hazards to motor vehicles, 52. Public Services. Will the proposal have an effect upon, or result in a need for new or altered governmental services in any of the following areas: a. Fire protection? b. Police protection? c. Schools? d. Parks or other recreational facilities? e. Maintenance of public facilities, including roads? f. Other governmental services? 53. Energy. Will the proposal result in: a. Use of substantial amounts of fuel or energy? b. Substantial increase in demand upon existing sources of energy, or require the development of new sources of energy? 54. Utilities. Will the proposal result in a need for new systems, or substantial alterations to the following utilities: a. Power or natural gas? b. Communications systems? c. Water? d. Sewer or septic tanks? e. Storm water drainage? -8- • • f. Solid waste and disposal? 55. Human Health. Will the proposal result in: a. Creation of any health hazard or potential health hazard (excluding mental health)? b. Exposure of people to potential health hazards? 56. Aesthetics. Will the proposal result in the obstruction of any scenic vista or view open to the public, or will the proposal result in the creation of an aesthetically offensive site open to public view? 57. Recreation. Will the proposal result in an impact upon the quality or quantity of existing receational opportunities? 58. Cultural Resources. a. Will the proposal result in the alteration of or the destruction of a prehistoric or historic archeological site? b. Will the proposal result in adverse physical or aesthetic effects to a prehistoric or historic building, structure, or object? c. Does the proposal have the poten- tial to cause a physical change which would affect unique ethnic cultural values? d. Will the proposal restrict existing religious or sacred uses within the potential impact area? YES MAYBE NO • 59. Mandatory Findings of Significance. a. Does the project have the poten- tial 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 commun- ity, reduce the number or restrict the range of a rare or endangered plant or animal or eliminate important examples of the major periods of California history or prehistory? b. Does the project have the poten- tial to achieve short-term, to the disadvantage of long-term, environ- mental goals? (A short term impact on the environment is one which occurs in a relatively brief, definitive period of time while long-term impacts will endure well into the future . ) c. Does the project have impacts which are individually limited, but cumulatively considerable? (A project may affect two or more separate resources where the impact is relatively small, but where the effect of the total of those impacts on the environment is significant.) d. Does the project have environ- mental effects which will cause substantial adverse effect on human beings, either directly or indirectly? YES MAYBE NO • • NOTE: Before the Lead Agency can accept this application as complete, the applicant must consult the lists prepared pursuant to Section 65962.5 of the Government Code and submit a signed statement indicating whether the project and any alternatives are located on a site which is included on any such list, and shall specify any list. HAZARDOUS WASTE AND SUBSTANCES STATEMENT The development project and any alternatives proposed in this application are contained on the lists compiled pursuant to Section 65962.5 of the Government Code. Accordingly, the project applicant is required to submit a signed statement which contains the following information: 1. Name of applicant: C W • gall 9 � I %lt'e • 2. Address: 2J0 I LLGRI T- Vw1 0>(A)t.3 I I , )1\1 14-I L L ' 'jam S / (" .. R b 2.7 el- (7)Io)54-1- 9W 3. Phone Number: 4. Address of Site (street name and number if available, and ZIP code): 1 t')11r)7.-)� 5. Local Agency (city/county) : � I () T-1fDLiu1,t. 1 -1 its 6. Assessor's book, page, and parcel number: (1)0(3, 11. RP30-133 r, 1).6 15/-,'7--00%-0'Lc, 7. Specify any Code: list pursuant to Section 65962.,5 of the Government C. rat__ ! ..�1. r��► l�.l ( , CA k ,c4Z PAW 114A AA/64/ 10454 4 8. Regulatory identification number: 1-40C4Ea LISTMC> 9. Date of List: Date ‘ I % 1 q3 L.\ 1992, Signature) Applicant) -11- 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 1 ativ;as proposed in this application are not contained on h ' ts. Date 116P /95 111 tk � ature) For (Applicant) CERTIFICATION: I hereby certify that the statements furnished above and in the attached exhibits present the data and information required for this initial evaluation to the best of my ability, and that the facts, statements,g aryl •nform4ti,p�i presented are true and correct to the best of mykno le a ar, ief. Date ) 1 (D (9. For ature) (Applicant)