PROJECT ADDRESS ASSESSOR S PARCEL NUMBER G.P. LAND USE DESIGNATION ZONING DISTRICT FLOOD HAZARD ZONE SITE ACREAGE AIRPORT SAFETY ZONE?

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TYPE OR PRINT CLEARLY Submit Completed Applications to: City of Corning Planning Dept. 794 Third Street Corning, CA 96021 PROJECT ADDRESS ASSESSOR S PARCEL NUMBER G.P. LAND USE DESIGNATION ZONING DISTRICT FLOOD HAZARD ZONE SITE ACREAGE AIRPORT SAFETY ZONE? PROJECT INFORMATION PROJECT DESCRIPTION: (attach additional sheets if necessary) APPLICATION TYPE (Check All Applicable) Annexation/Detachment General Plan Amendment Lot Line Adjustment Merge Lots Planned Dev. Use Permit Parcel Map Preliminary Plan Review Rezone Street Abandonment Subdivision Time Extension Use Permit Variance Other APPLICANT ADDRESS DAY PHONE REPRESENTATIVE (IF ANY) ADDRESS DAY PHONE APPLICANT INFORMATION PROPERTY OWNER ADDRESS DAY PHONE CORRESPONDENCE TO BE SENT TO APPLICANT REPRESENTATIVE PROP. OWNER APPLICANT/REPRESENTATIVE: I have reviewed this application and the attached material. The information provided is correct. Signed: PROPERTY OWNER: I have read this application and consent to its filing. Signed: By signing this application, the applicant/property owner agrees to defend, indemnify, and hold the City of Corning harmless from any claim, action, or proceeding brought to attack, set aside, void or annul the City s approval of this application, and any Environmental Review associated with the proposed project. SUBMITTAL INFO FOR OFFICE USE ONLY APPLICATION NO. RECEIVED BY: DATE RECEIVED DATE APPL. DEEMED COMPLETE FEES RECEIVED/RECEIPT NO. CEQA DETERMINATION DATE FILED Exempt ND MND EIR Page 1 of 5

CITY OF CORNING ENVIRONMENTAL INFORMATION FORM (To be completed by Applicant) General Information DATE FILED 1. Project Title: 2. 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: Additional Project Information 3. For non-residential projects, indicate total proposed building floor area: sq. ft. in floor(s). 4. Amount of off-street parking to be provided. parking stalls. (Attach plans) 5. Proposed scheduling/development. 6. Associated project(s). 7. If residential, include the number of units, schedule of unit sizes, range of sale prices or rents, and type of household size expected. (This information will help the City track compliance with the objectives of the Housing Element of the General Plan.) Page 2 of 5

8. If commercial, indicate the type, whether neighborhood, city or regionally oriented, square footage of sales area, and loading facilities. 9. If industrial, indicate type, estimated employment per shift, and loading facilities. 10. If institutional, indicate the primary function, estimated employment per shift, estimated occupancy, loading facilities, and community benefits to be derived from the project. 11. If the project involves a variance, conditional use permit or rezoning application, state this and indicate clearly why the application is required. Are the following items applicable to the project or its effects? Discuss below all items checked yes (attach additional sheets as necessary). YES NO 12. Change in existing topographic features, or substantial alteration of ground contours? 13. Change in scenic views or vistas from existing residential areas or public lands or roads? 14. Change in pattern, scale or character of general area of project? 15. Significant amounts of solid waste or litter? 16. Change in dust, ash, smoke, fumes or odors in vicinity? 17. Change in lake, stream or ground water quality or quantity, or alteration of existing drainage patterns? 18. Substantial change in existing noise or vibration levels in the vicinity? 19. Is the site on filled land or on slopes of 10 percent or more? 20. Use, storage, or disposal of potentially hazardous materials, such as toxic substances, flammables or explosives? 21. Substantial change in demand for municipal services (police, fire, water, sewage, etc.)? 22. Substantially increase energy usage (electricity, oil, natural gas, etc.)? 23. Relationship to a larger project or series of projects? Page 3 of 5

Environmental setting 24. Describe the project site as it exists before the project, including information on topography, soil type and 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. 25. 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 (onefamily, apartment houses, shops, department stores, etc.), and scale of development (height, frontage, setback, rear yard, etc.). Attach photographs of the vicinity. Snapshots or Polaroid photos will be accepted. 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 Signature For: Page 4 of 5

Required Supplementary Information: (Note: The following are general requirements for the various types of projects. Additional information due to site or neighborhood characteristics or conditions may also be required) General Plan Amendment: 1. Assessor s Map 2. Copy of Vesting Deed or Preliminary Title Report for all properties 3. Application fee (See Fee Schedule) Lot Line Adjustment: for each affected property 2. Drawing marked Exhibit A (prepared by a Licensed Land Surveyor or Civil Engineer) showing existing and proposed parcel boundaries, streets, buildings, utilities 3. Resulting parcel descriptions marked Exhibit B 4. Application fee (See Fee Schedule) Planned Development Use Permit 2. Drawing showing proposed uses of sufficient detail to identify all facets of the project, including any proposed divergence from typical City standards (setbacks, lot coverage, density, etc.) 3. A narrative describing and justifying all proposed divergence from typical City standards Parcel Map (Submit City of Corning Tentative Map Package) Rezone or Prezone 2. Application fee (See Fee Schedule) Street Abandonment 1. Letter of Justification 2. Application fee (See Fee Schedule) Subdivision (Submit City of Corning Tentative Map Package) Time Extension: 1. Application fee (See Fee Schedule) Use Permit: 1. Site Plan (drawn to scale) indicating existing and proposed uses, adjacent streets, utilities, driveways, parking areas, landscaped areas, signage, etc. 2. Copy of Preliminary Title Report 3. Application fee (See Fee Schedule) Variance: 2. Ten (10) copies of a site plan (drawn to scale) ) indicating all existing and proposed uses, adjacent streets, utilities, driveways, parking areas, etc. and the issue for which the variance is sought. 3. One reduced size (8 ½ X 11 ) copy of the site plan. 4. Application fee (See Fee Schedule) 5. Narrative supporting and justifying the findings listed in Zoning Code Section 17.58.020. 6. Application fee (See Fee Schedule) Page 5 of 5