none, Plan for pool foundation repai, ApplicationAPPLICATION FOR ADMINISTRATIVE APPROVAL
(Over the counter approval pursuant to Zone Clearance,
Chapter 17.44 of the Rolling Hills Zoning Ordinance)
PROPERTY OWNER'S NAME
�Iu,tbra4o! Kai i7/ JA� ,4''Ys -7y
OWNER'S ADDRESS (/
/ _
OWNER'S/14ELEyPH-ONE & EMAIL
V I
i Af4,6 rat,4 A€. tee t/ , eitt goe7V
PROPERTYAdDRESS (/
W �[
AGENT'S NAME
AGENT'S ADDRESS
•AGENT'S TELEPHONE & EMAIL
NATURE OF PROPOSED PROJECT
-, -
Describe in detail the nature of the proposed project:
Adm. Approval Rev.
Page 8 of 17 4/2016
Describe the proposed use(s) of the project:
PROPERTY OWNER'S ACKNOWLEDGMENT,
I (We) declare that I (We) am (are) familiar with City's rules as they relate to this
project and with the submittal and construction requirements.
Incomplete applications will delay the approval process.
I- (We) also understand that other than the City, prior to start of construction,
approval and building permits are required from the RHCA and Department of
Building and Safety and that any modification, change or variation to the approved
plans must be reviewed andapproved by the agencies listed above prior to
commencing such construction.
I (We) declare under penalty of perjury that the foregoing application is true and
correct.
By. . �j Date: 7 ////( 1
Pro
By: - / Date: if
Pr f perty. owner
10014 relk.14 20 /6447/f eJnOL7y
Address
tztd/1;.Aib �IS
d City
Adm. Approval Rev.
Page 9 of 17 4/2016
DATE: 0 ADDRESS:
ALL MEASUREMENTS TO BE TAKEN FROM THE EXTERIOR FINISHED SURFACE
OF STRUCTURES AND OUTSIDE BEAMS ON TRELLISES; ALL STRUCTURES ON
THE LOT MUST BE SHOWN ON THE PLAN AND LISTED HERE
CALCULATION OF LOT COVERAGE
AREA AND
STRUCTURES EXISTING PROPOSED TOTAL
NET LOT AREA )S470 sq.ft.
RESIDENCE/-- sq.ft. sq.ft.} sq.ft.
GARAGE ) sq.ft. sq.ft. ,�) sq.ft.
SWIMMING POOL/SPA ;31—sq.ft. sq.ft. 4 sq.ft.
POOL EQUIPMENT sq.ft. sq.ft. ',. sq.ft.
GUEST HOUSE sq.ft. sq.ft. sq.ft.
CABANA sq.ft. sq.ft. ` -. sq.ft.
STABLE 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.
*DETACHED STRUCTURES:
(circle all that applies)
SHEDS, TRELLISES, GAZEBO. sq.ft.
BARBECUE;•OUTDOOR KITCHEN, sq.ft.
ROOFED PLAY EQUP.- over 15 ft. sq.ft.
high and over 120 sq. ft. in area,
WATER FEATURES, ETC. sq.ft.
SERVICE YARD sq.ft.
OTHER 'ccsq.ft.
BASEMENT AREA • -• sq.ft.
(volume of dirt) — c.y.
DEPTH OF BASEMENT
TOTAL STRUCTURES a7sq.ft.
% STRUCTURAL COVERAGE - %
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.
TOTAL STRUCTURES
EXCLUDING UP TO 5 & UP TO
800 sq. ft. detached structures t t
are not higher than 12 ft.sq.ft. sq.ft.-7, sq.ft.
% STRUCTURAL COVERAGE 21 %
Adm. Approval Rev.
Page 10 of 17 4/2016
ALL FLATWORK MUST BE SHOWN ON THE PLAN AND LISTED HERE
PRIMARY DRIVEWAY(S)
PAVED WALKS, PATIO
AREAS, COURTYARDS
POOL DECKING
sq.ft. sq.ft.
sq.ft. sq.ft.
sq.ft.
sq.ft.
sq.ft. 61a sq.ft. L225.ft.
OTHER PAVED DRIVEWAYS,
ROAD EASEMENTS, PARKING
PADS f.ti �� : ' ' j;' sq.ft..
TOTAL FLATWORK
% TOTAL FLATWORK
COVERAGE
I (i) r sq.ft. sq.ft.
sq.ft. )ag8.' sq.ft. I/?2SsGq.ft.
TOTAL STRUCTURAL & 4,t4.ft.
FLATWORK COVERAGE
% TOTAL COVERAGE :_.� --� � % (. ' 4% ' ' %
TOTAL STRUCTURAL &
FLATWORK COVERAGE
Excl. the allowance of up to 5 — 800 sq. ft.
structures from previous page.
sq.ft.
sq.ft. sq.ft.
% TOTAL COVERAGE
TOTAL SQ.FT. OF PERVIOUS SURFACES (Other than landscaping;
i.e. D.G., pavers set in sand, grass crete)
TOTAL DISTURBED AREA . sq.ft.
% DISTURBED AREA
sq.ft.
1
sq.ft.
sq.ft.
All structures (attached and detached) must be listed. ,
* Miscellaneous conforming free standing accessory structures such as sheds, trellises,
covered patios, gazebo, fountains, barbecue, outdoor fire place, .etc. are not counted
towards coverages unless greater than 120 s.f., (except for trellises), their combined area
exceeds 800 sq. ft., or if there are more than 5 such structures on the property.
Adm. Approval Rev.
Page 11 of 17 4/2016
DATE
PAD NO.1
ADDRESS: (
0491-10 riP„
CALCULATION OF BUILDING PAD COVERAGE
BUILDABLE PAD AREA EXISTING PROPOSED TOTAL
ANT) STRUCTURES
BUILDING PAD sq.ft. cq.ft. - cq.ft.
RESIDENCE ?/ 57 sq.ft. sq.ft. 3I `SW cq.ft.
GARAGE (� 0 sq.& cq.ft. a 5 0 cq.ft.
POOL/SPA `' — sq.ft. sq.ft. < t sq.ft.
POOL EQUIPMENT sq.ft. sq.ft. sq.ft.
CABANA/REC.RM sq.ft. cq.ft. sq.ft.
GUEST HOUSE sq.ft. cq.ft. sq.ft.
STABLE sq.ft. Nq.ft. sq.ft.
SPORTS COURT cq.ft. sq.ft. sq.ft.
SERVICE YARD sq.ft. sq.ft. sq.ft.
ATTACHED COVERED PORCHES�
Primary residence 7 sq ft sq.ft. !vim sq ft
Accessory structures sq.ft. sq.ft. sq.ft.
AREA OF ATTACHED COVERED cq.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 lot coverage page)
ALL DETACHED STRUCTURES cq.ft. sq.ft. sq.ft.
(from lot coverage page; minus deductions)
OTHER 1? % 4 H sq.ft. sq.ft. cq.ft.
TOTAL STRUCTURES ON PAD NO. 1 sq.ft. cq.ft. 5 5�q.ft.
% BUILDING PAD COVERAGE 74- % % ?—'P 1 %
TOTAL STRUCTURES ON PAD NO. l sq.ft. cq.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/accs. structures.
% BUILDING PAD COVERAGE 2-1- % % 74 %
Adm. Approval Rev.
Page 12 of 17 4/2016
DATE: ADDRESS:
CALCULATION OF BUILDING PAD COVERAGE
PAD NO.2
N/A
BUILDABLE PAD AREA EXISTING PROPOSED TOTAL
AND STRUCTURES
BUILDING PAD sq.ft. sq.ft. cq,ft,
RESIDENCE sq.ft. sq.ft. cq.ft.
GARAGE sq.ft. sq.ft. cal.ft.
POOL/SPA sq.ft. sq.ft. sq.ft.
POOL EQUIPMENT sq.ft. sq.ft. ct.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 cq.ft, sq.ft. sq.ft.
ATTACHED COVERED PORCHES
Primary residence sq.ft. sq.ft. sq.ft.
Accessory structures sq.ft. cq,ft. sq.ft.
AREA OF ATTACHED COVERED sq.ft. sq.ft. sq.ft.
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 previous page)
ALL DETACHED STRUCTURES sq.ft. sq.ft. sq.ft.
(from previous page not including allowed deductions)
OTHER sq.ft. sq.ft. sq.ft.
TOTAL STRUCTURES ON PAD NO. 1 sq.ft. sq.ft. sq.ft.
% BUILDING PAD COVERAGE % % %
TOTAL STRUCTURES ON PAD NO. 1 sq.ft. ci1.ft. sq.ft.
Not incl, attached trellises,
Not incL allowed deductions,
andincL the area of covered porches that exceed 10% of the size of the residence/accs. structures.
% BUILDING PAD COVERAGE % olo %
Adm. Approval Rev.
Page 13 of 17 4/2016
DATE: ADDRESS
DRIVEWAY(S) AND MOTOR COURT(S)
NOTE: The information below is to be submitted for all new developments, garage
addition, modification or relocation and for any modification to existing driveway(s) and
motor court(s). If no changes are proposed to the existing driveway or motor court, except
for reconstruction/repaving, within existing footprint, provide information for the total
pervious and impervious surfaces.
Pursuant to Section 17.16.150 of the Rolling Hills Zoning Code, driveways may not cover
more than 20% of the setback area in which they are located and uncovered parking
areas/motor courts may not cover more than 10% of the front or side yard setback.
Uncovered parking areas shall be located no closer than 30-feet from any roadway
easement line. For properties that qualify for reduced setbacks (Sec. 17.17 and 17.24.045)
min. of 40% of the front yard area shall be landscaped & only one driveway is allowed.
A not to exceed 3-foot high wall may be permitted along a driveway or stairway in any
setback. If any of these improvements are in easements, RHCA approval is required prior
to City's review.
Adm. Approval Rev.
Page 14 of 17 4/2016
CALCULATION OF DRIVEWAY(S) AND MOTOR COURT(S) COVERAGE;
IMPERVIOUS/PERVIOUS SURFACES AND
INCLUDING FIRE DEPARTMENT TURN AROUND, IF REQUIRED
TOTAL DRIVEWAY(S)
TOTAL MOTOR COURT(S)
& PARKING PAD(S)
AREA OF FRONT SETBACK
AREA OF SIDE SETBACK
EXISTING TOTAL PROPOSED
lDlf3 s.f. s.f
s.f. s.f
s.f.
s.f
AREA OF DRIVEWAY(S) s.f. s.f
IN SIDE SETBACK
% OF SIDE SETBACK % %
COVERED BY DRIVEWAY(S)
AREA OF MOTOR COURT(S) s.f. s.f
& PARKING PADS IN SIDE SETBACK
% OF SIDE SETBACK
COVERED BY MOTOR
COURT(S) & PARKING PAD(S)
AREA OF DRIVEWAY(S) /C7 j8 s.f. s.f.
IN FRONT SETBACK
% OF FRONT SETBACK % % '
COVERED BY DRIVEWAY(S)
AREA OF MOTOR COURT(S) J/ 0I� s.f. s.f
& PARKING PADS IN FRONT SETBAC K
% OF FRONT SETBACK 1C� % %
COVERED BY MOTOR 1
COURT(S) & PARKING PAD(S)
IMPERVIOUS SURFACE
PERVIOUS SURFACE
s.f. s.f.
018 s.f. M'63 s.f.
Adm. Approval Rev.
Page 15 of 17 4/2016
SUMMARY OF ACCESSORY STRUCTURES
COUNTED/NOT COUNTED
TOWARDS LOT COVERAGE:
BUILDING PAD COVERAGE: (guideline - 30% maximum pad coverage).
All structures, including porte cochere, breezeway and entryway, shall be
counted towards building pad coverage, except for the following:
ATTACHED STRUCTURES:
• Attached covered porch having an area of 10% or less of the size of the
structure that it is attached to,
• Attached trellises (open roof)
DETACHED STRUCTURES: (not to exceed a total of 5 such structure on a
lot, not to exceed 12 feet in height, not to exceed 120 sq.ft. each, (see exceptions
below), and not to exceed a combined total of 800 sq.ft.)
• Storage sheds; max. 2 on a lot,
• Trellis and freestanding covered patio w/solid roof, (may exceed 120 sq.ft.),
• Outdoor bar, barbecue, fire place, gazebo,
• Roofed playground fort, (may be max. 15 ft.),
• fountain, pond and similar structures.
These structures may not be located in the front yard area or any setback,
. except for a fountain, decorative pond or low water feature.
STRUCTURAL AND TOTAL LOT COVERAGE AND DISTURBANCE:
(Zoning Code requirement: max. - 20% structural coverage; max. - 35% total lot
coverage; max. - 40 % lot disturbance -see exceptions).
All attached structures, including porches, trellises, porte cochere, breezeway, and
entryway shall be counted towards coverage.
All detached structures shall be counted towards coverage, except for the
following:
DETACHED STRUCTURES: (not to exceed a total of 5 such structure on a
lot, not to exceed 12 feet in height, not to exceed 120 sq.ft. each, (see exceptions
below), and not to exceed a combined total of 800 sq.ft.)
• Storage sheds; max. 2 on a lot,
• Trellis and freestanding covered patio w/solid roof, (may exceed 120 sq.ft.),
! Outdoor bar, barbecue, fire place, gazebo,
• Roofed playground fort, (may be max. 15 ft.),
• Fountain, pond and similar water feature, 3' high or less.
These structures may not be located in the front yard area or any setback,
except for a fountain, decorative pond or low water feature.
Adm. Approval Rev.
Page 16 of 17 4/2016
Property Line
Easement Line
Setback Line
10 ft
excluded
Residence
................
•
ROAD WAY
EASEMENT
T
NET LOT AREA
EXCLUDE
ROADWAY EASEMENTS PLUS
10 FEET AT PERIMETER OF THE
ENTIRE PARCEL INCL. ALONG ROADWAY
EASEMENT
NET LOT AREA CALCULATIONS
Adm. Approval Rev.
Page 17 of 17' 4/2016
PROPERTY OWNER:
L3z.-,,k; d 4. /. .
o/ ie0t&ng JiIL
VARIANCE
REOUEST FOR HEARING
Mrs. tih ryjet, e
OWNER'S ADDRESS: f 0pe' $r'am koae&
TELEPHONE NO.: C3/o) G 6 2
PROPERTY ADDRESS: `#/ 13-ti �C l e"4- �i
LEGAL DESCRIPTION: LOT NO. //g—
INCORPORATED JANUARY 24, 1957
NO. 2 PORTUGUESE BEND ROAD
ROLLING HILLS, CALIF. 9D274
(310) 377-1521
FAX (310) 377-7288
ASSESSOR'S BOOK NO.75.67 PAGE °O4 PARCEL o33
AGENTS NAME: Pra." �. -/O' 6 - 4vc4;.Mi
AGENTS ADDRESS: 0 3 4*10 Ao (Pset F'". Cie a /;, 90 7io
TELEPHONE NO.: ( 1) 3Zb - 5114 a c/ Pt20 (3r)) �3 � - `70 z
Describe in detail the nature of the proposed use, including what aspects of the project
• require a Variance.
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.
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
•
FILING FEE
A filing fee must accompany the application. Make check payable to: THE CITY OF
ROLLING HILLS.
DATE
ZONING CASE NO. ADDRESS 4/ D/h lY tc 4+ �ba-d
BUILDING AREAS
NET LOT AREA
BUILDING PAD(S)
RESIDENCE
GARAGE
SWIMMING POOL/SPA
STABLE
RECREATION COURT
( )
SERVICE YARD
OTHER a dt 41°"4se 7 0
NEW BASEMENT AREA
(Volume to be included in grading quantities.)
APPLICANT
.S-_/S- G I
CALCULATION OF LOT COVERAGE
EXISTING PROPOSED TOTAL
/�f, 9 �o
4'7oo
sq.ft.
sq.ft.
3�57 s sq.ft.
6 So sq.ft.
5S sf sq.ft.
sq.ft.
TOTAL STRUCTURES
% STRUC:TU1jAL
COVERAGE ,F �'
% TOTAL PAD
COVERAGE
sq.ft.
sq.ft.
sq.ft.
3fi0
70
sq.ft. /69° sq.ft.
sq.ft.
sq.ft. 1 s75 sq.ft.
sq.ft. 6 50 sq.ft.
sq.ft. S SSL sq.ft.
sq.ft. $ o sq.ft.
sq.ft.
sq.ft.
sq.ft.
4� 7 0 0 sq.ft.
�-' sq.ft.
sq.ft.
sq.ft.
sq.ft. 3!o sq.ft. S/ S9 sq.ft.
. I %v .44c %
DRIVEWAY 3 oI t3 sq.ft.
PAVED WALKS AND
PATIO AREAS
POOL DECKING
TOTAL FLATWORK
% TOTAL FLATWORK
COVERAGE
76 ° sq.ft.
S3 a sq.ft.
11-11> $ sq.ft.
26.0
TOTAL STRUCTURAL & FLATWORK
COVERAGE q/57 sq.ft.
% TOTAL COVERAGE t/. 3 %
6, (o % /oq. 7
sq.ft.
— sq.ft.
sq.ft.
sq.ft.
�- %
c sq.ft.
3 0/ 8 sq.ft.
76o sgft
•
5-3 0 sq.ft.
43° sq.ft.
26.
7546 7 sq.ft.
63. .%
DATE ZONING CASE NO. ADDRESS ' / 0iea S''4+0C gOadC
APPLICANT
• -^<- .ct. . -/� - 6/
CALCULATION OF BUILDING PAD COVERAGE
PAD NO. 1
BUILDABLE PAD AREA
RESIDENCE
GARAGE
STABLE (BARN)
POOL J44.A7.- i
RECREATION COURT
l )
OTHER
TOTAL STRUCTURES ON PAD NO. 1
% BUILDING PAD COVERAGE
S<7oo
sq.ft.
sq.ft.
sq.ft.
sq.ft.
sq.ft.
sq.ft.
sq.ft.
sef %c&s...)
S/S7 sq.ft.
/0 7.7 % e30 `,
PAD NO. 2
BUILDABLE PAD AREA sq.ft.
RESIDENCE sq.ft.
GARAGE sq.ft.
STABLE (BARN) sq.ft.
POOL sq.
RECREATION COURT
OTHER
sq.ft.
sq.ft.
TOTAL STRUCTURES ON PAD NO. 2 sq.ft.
% BUILDING PAD COVERAGE %
9. Total square footage of structures
10. Number of floors of construction
11. Basement square footage A)/4.
Date Filed
City 0/ Ie0/fi Jl•??,
(; - A 1 "e t-k'c ___ .r -. I4 .
�S.-ZGI
ENVIRONMENTAL INFORMATION FORM
(To Be Completed By Applicant)
Zoning Case No.
INCORPORATED JANUARY 24, 1957
GENERAL INFORMATION
1. Applicant(s) Tel. ( )
Address
2. Legal Owner(s) -'' l �Ivs JD tf u P'etip Tel. ()
NO. 2 PORTUGUESE BEND ROAD
ROLLING HILLS, CALIF. 90274
(310) 377-1521
FAX: (310) 377-7288
E-mail: cityofrh@aof.com
.5�1/• y66Z
Address `/ Off 11 $ ".0( Pad{. , (Op//i:d5 fii/is c/% 7627g
3. Project Address g/ z Iavn.4•1 R-X • Pa /i — /'- /fs ,
Assessor's Book No. 7‘ 67 Oo r{ - 6 33 Lot No. //6 ' 'g
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
6. Proposed project/use of site f26I-e
PROJECT DESCRIPTION
7. Site size
8. Net lot area . "Net Lot Area" means the total area included within the lot lines of
the lot or parcel of property, exclusive of: (a) the entire area within a recorded roadway easement
plus the area within ten (10) feet measured perpendicular to the edge of the roadway easement;
(b) the ten (10) foot perimeter of the lot perpendicular to the property lines; (c) any private drive or
driveway that provides access to any other lot orsparcel; and (d) the access strip portion of a flag
lot."
'4!)
I-1
March 20, 200D
Environmental Information Form
® Pt rote' f„1 {1f•(:vt:010 r:1174:1
12. Total combined flatwork and structural lot coverage
13. Will any exterior walls be removed or relocated? Which walls? 150
14. Will any interior walls be removed or relocated? Which walls? a
15. Will the entire building structure require a new roof?
16. Will the existing roof remain intact, with Tess than 200 square feet added? " #1/4
-17. Driveway Access and Parking: -.
a Is a new driveway accessway proposed? tO o (Requires Traffic Commission Review).
b. Number of driveway(s) Existing? Proposed?
(Second driveway requires approved Conditional Use Permit from Planning Commission).
c. Width of driveway(s) Existing? Proposed?
(Maximum of 20 foot width unless approved by the Planning Commission).
d. Does first 20 feet of driveway have a maximum grade of 7%?
(Maximum of 7% for first 20 feet of driveway required).
Existing? Proposed?
e. Grade of driveway(s)? Existing? 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?
�� Explain
4, al/f4JITZak
Does uncovered parking area cover more than a maximum 10% of the area of the yard in
which it is located?
Explain •
• i. Does vehicular accessway to stable and corral have a maximum slope of 25% or
less? LESS Stable and corral average vehicular access slope
j. Does property have an above ground garage with a minimum capacity of
2 cars? let With guest house a minimum of 3 cars?
18. Grading quantities shall be balanced. Amount cut L. O — . Amount fill - C) -
(Include any basement cut in grading quantities).
19. Area of disturbance. 40% of net lot area maximum; any remedial grading (temporary disturbance),
any graded slopes and building pad areas, and any nongraded area where impervious surfaces
will remain or are proposed to be added.
Square feet . Percentage of Net Lot Area
20. If residential, include the unit size. Square feet
March 20, 2000
Environmental Information Form
1-2
21: If commercial, indicate the type of project, whether neighborhood, city or regionally oriented,.
square footage of sales area, estimated employment per shift and loading facilities.
,v/A
22. If industrial, indicate the type of project, estimated employment per shift, and loading facilities.
eh
23. If institutional, indicate the major function, estimated employment per shift, estimated occupancy,
loading facilities, and community benefits to be derived from the project.
OM-
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.
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.
March 20, 2000
Environmental Information Form
1-3
28. Describe the surrounding properties, including information
"historical or scenic aspects. Indicate the type of land use
of land use (one -family, guest house, office use, etc
frontage, set -back, rear yard, etc.). Attach photographs
photos will be accepted.
29. Is the proposed project consistent with:
City of Rolling Hills General Plan
Applicable Specific Plan
City of Rolling Hills Zoning Ordinance
South Coast Air Quality Management Plan
Congestion Management Plan
Regional Comprehensive Plan
30. Have any of the following studies been submitted?
Geology Report
Hydrology Report
Soils Report
_ Traffic Study
_ Noise Study
Biological Study
Native Vegetation
Preservation Plan
_ Solid Waste Generation Report
_ Public Services/
Infrastructure Report
1-4
�b
on plants and animals and any cultural,
(residential, commercial, etc.), intensity
.) and scale of development (height,
of the vicinity. Snapshots or polaroid
Yes
No
N/A
•
_ Historical Report
Archaeological Report
Paleontological Study
_ Line of Sight Exhibits
_ Visual Analysis
Slope Map
Fiscal Impact Analysis
_ Air Quality Report
_ Hazardous Materials/
Waste
f'd- S - /s- o/
March 20, 2000
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. If 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 BR 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.
S'- o
March 20, 2000
Environmental Information Form
1-5
Issues:
EIESTHETICS,— 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 0 0
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?
0
CI
0
AGRICULTURE RESOURCES:
In determining whether impacts to agricultural 0 0 ❑
resources are significant environmental effects, lead
agencies may refer to the California Agricultural Land
Evaluation and Site Assessment Model (1997)
prepared by the California Dept. of Conservation as an
optional model to use in assessing impacts on
agriculture and farmland. Would the project:
a) Convert Prime Farmland, Unique Farmland, or 0 0 0
Farmland of Statewide Importance (Farmland), as
shown on the maps prepared pursuant to the
Farmland Mapping and Monitoring Program of the
California Resources Agency, to non-agricultural use?
b) Conflict with existing zoning for agricultural use, or a 0 0 0
Williamson Act contract?
c) Involve other changes in.the existing environment 0 ❑ 0
which, due to their location or nature, could result in
conversion of Farmland, to non-agricultural use?
•t1. FAIR 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 ❑ 0 ❑
applicable air quality plan?
March 20, 2000
Environmental Information Form
1-6
b)
Violate any air quality standard or contribute
substantially to an existing or projected air quality
violation?
c) Result in a cumulatively considerable net increase of
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?
❑ ❑
❑ ❑
❑ O O
❑ ❑ O
0
�V. pIOLOGICAL RESOURCES. -- Would the project::
a) Have a substantial adverse effect, either directly or 0 0 ❑
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 ❑ ❑
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 ❑ O 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 ❑
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 ❑
biological resources, such as a tree preservation
policy or ordinance?
f) Conflict with the provisions of an adopted Habitat 0 0 0
Conservation Plan, Natural Community Conservation
Plan, or other approved local, regional, or state
habitat conservation plan?
March 20, 200D
Environmental Information Form
1-7
V CULTURAL RUSOURCES — Would the project:
a) Cause a substantial adverse change in the significance 0 0 0
of a historical resource as defined in §15064.5 of the
State CEQA Guidelines?
b) Cause a substantial adverse change in the 0 0 0
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
resource or site or unique geologic feature?
d) Disturb any human remains, including those interred 0 ❑ 0
outside of formal cemeteries?
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:
)3(
i) Rupture of a known earthquake fault, as delineated 0 ❑ . 0 A
on the most recent Alquist-Priolo Earthquake Fault
Zoning Map issued by the State Geologist for the
area or based on other substantial evidence of a
known fault? Refer to Division of Mines and Geology
Special Publication 42.
ii) Strong seismic ground shaking? • 0 0
iii) Seismic -related ground'failure, including 0 0
liquefaction?
iv) Landslides? 0 0
b) Result in substantial soil erosion or the loss of topsoil? 0 0
c) Be located on a geologic unit or soil that is unstable, 0 0
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
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?
0
S-/s- t
March 20, 2000
Environmental Information Form
I-8
VI . JIAZARDS AND HA7,ARDOUS MATERIALS_
Would the project:
a) Create a significant hazard to the public or the
environment through the routine transport, use, or
disposal of hazardous materials? .
b) Create a significant hazard to the public or the 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 ❑ ❑
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 f8�
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
would the project result in a safety hazard for people
residing orworking in the project area? •
g) Impair implementation of or physically interfere with an ❑ ❑ 0
adopted emergency response plan or emergency
evacuation plan?
h) Expose people or structures to a significant risk of 0 ❑ 0
loss, injury or death involving wildland fires, including
where wildlands are adjacent to urbanized areas or
where residences are intermixed with wildlands?
March 20, 2000
Environmental Information Form
1-9
V1jj. HYDROLOGY AND WATER QUALITY
--Would the project:
a) Violate any water quality standards or waste discharge 0 ❑ 0
requirements?
b) Substantially deplete groundwater supplies or 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
site or areas including through the alteration of the
course of a stream or river, in a manner which would
result in substantial erosion or siltation on- or off -site?
d) Substantially alter the existing drainage pattern of the 0 0 0
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 stormwater
drainage systems or provide substantial additional
sources .of polluted runoff?
f) Otherwise substantially degrade water quality? 0 0 0 A(
g) Place housing within a 100-year flood hazard area as 0 ❑ 0 A
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 0 igt
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? ❑ 0 0 /131
•cf—•
March 20, 2000
Environmental Information Form
1-10
LAND USE AND PLANNING -- Would the project:
a) Physically divide an established community?
b) Conflict with any applicable land use plan, policy, or . ❑ 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?
0
c) Conflict with any applicable habitat conservation plan or ❑
0
0
0 0
natural community conservation plan?
. MINERAL RESOURCE — Would the project: .
a) Result in the loss of availability of a known mineral 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
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 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
levels in the project vicinity above levels existing
without the project?
d) A substantial temporary or periodic increase in ambient 0 0 0 X
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 X
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 g
the project expose people residing or working in the
project area to excessive noise levels?
March 20, 2000
Environmental Information Form
Cul . POPULATION AND HOUSING— Would the project:
a) Induce substantial population growth in an area, either 0 0
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
necessitating the construction of replacement
housing elsewhere?
c) Displace substantial numbers of people, necessitating 0 ❑
the construction of replacement housing elsewhere?
0
0
Cam. 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 P,
Police protection? 0 0 0
Schools? 0 0 ❑
Parks? ❑ 0 ❑ ,R(
Other public facilities? • ❑ 0 ❑
XIV. RECREATION
a) Would the project increase the use of existing 0 0 0
neighborhood and regional parks or other
recreational facilities such that substantial physical
deterioration of the facility would occur or be
accelerated?
b) Does the project include recreational facilities or 0 0 0
require the construction or expansion of recreational
facilities which might have an adverse physical effect
on the environment?
25erL d'
March 20, 200D
Environmental Information Form
1-12
Ky. 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 a change in air traffic patterns, including either
an increase in traffic levels or a change in location that
results in substantial safety risks?
d) Substantially increase hazards due.to a design feature
(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)?
❑ ❑ ❑ X
❑ ❑ 0 frli
❑ 0 0 I
❑ 0 0 X
❑ 0 ❑ . X
❑ ❑ ❑ /4
❑ ❑ ❑ X
Item XVI. . UTILITIES AND SERVICE SYSTEMS —
Would the project:
a) Exceed wastewater treatment requirements of the 0 ❑ ❑
applicable Regional Water Control Board?
b) Require or result in the construction of new water or 0 ❑ 0
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 stormwater ❑ 0 ❑
. drainage facilities or expansion of existing facilities,
the construction of which could cause significant
environmental effects?
d) Have sufficient water supplies available to serve the 0 ❑ 0
project from existing entitlements and resources, or
are new or expanded entitlements needed?
March 20, 2000
Environmental Information Form
1-13
e) Resutt 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 0 ❑ ❑
to accommodate the project's solid waste disposal
needs?
g) Comply with federal, state, and local statutes and 0 ❑ 0
regulations related to solid waste?
XVII. 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 Califomia
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?
❑
❑ ❑ ❑
0
O ❑lgr
zed S"-/S• 61
March 20, 2000
Environmental Information Form
1-14
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
/3/41
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 it
required to submit a signed statement which contains the following information:
•
1. Name of applicant:
2. Address:
3. Phone Number:
4. Address of Site (street name and number if available, and ZIP code):
5. Local Agency (city/county):
6. Assessor's book, page, and parcel number:
7. Specify any list pursuant to Section 65962.5 of the Government Code: STATE OF CALIFORNIA
HAZARDOUS WASTE AND SUBSTANCES SITES LIST (available at City Halll,
S. Regulatory identification number:
9. Date of List: JULY 1992
Date
For
Signature
Applicant
I.7ecter- /5 - o i
March 20, 2000
Environmental Information Form
1-15
r
4
I
NOTE: In the event that the project site and any alternatives are not listed on any list compiled pursuant to
Section 65962.5 of the Government Code, then the applicant must certify that fact as provided below.
I have consulted the lists compiled pursuant to Section 65962.5 of the Government Code and hereby
certify that the development project and any alternatives proposed in this application are not contained on
these lists.
Date
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
1-16
March 20, 2000
Environmental Information Form