COMMUNITY AND ECONOMIC DEVELOPMENT DEPARTMENT

Mark J. Hendrickson Director COMMUNITY AND ECONOMIC DEVELOPMENT DEPARTMENT 2222 M Street Merced, CA 95340 (209) 385-7654 (209) 726-1710 Fax www.co.merced.ca.us Equal Opportunity Employer MINOR MODIFICATION TO ADMINISTRATIVE PERMITS AND CONDITIONAL USE PERMITS WHAT IS A MINOR MODIFICATION? A modification, or change, to a approved Administrative Permit or Conditional Use Permit may be approved by the Planning Director if it is minor in nature. A modification is considered minor if the Planning Director can make the following findings: 1. The modification will not have a significant effect on the environment; 2. The modification is a minor change to the approved permit form the standpoint of: the area, space, or volume occupied by the uses; 3. The modification will not be materially detrimental to other properties or land uses in the area. PROCESSING PROCEDURE: An applicant submits a request for a modification with an Environmental Information Form, a project description, a plot plan, a modification processing fee, and information indication how it meets the required findings above. A Planner is assigned and referrals are made to affect County Departments for a seven-day review and comment period. If there are existing uses on the property, they are reviewed by the Zoning Enforcement Officer for code compliance and to determine if there has been any complaints form the neighbors. After the seven-day review period, the modification is approved, conditionally approved or denied by the Planning Director and the applicant is informed in writing. Any decision of the Planning Director may be appealed to the Planning Commission within five days. MM to AA & CUP.doc

MINOR MODIFICATION FLOW CHART Application Submitted Planner Determines If Sufficient Grounds For Minor Modification And Fees Collected Minor Modification OR Major Modification Application Determined Exempt / Non Exempt New Administrative Permit Application New Conditional Use Permit Application (Either application follows applicable processing procedures.) Exempt From Environmental Review OR Initial Environmental Study * 7 Day Review / Comment From County Departments Directors Determination ** Permit Mailed To Applicant OR Appeal To Planning Commission Building Permit Or Use Established * See separate flow chart for more complete environmental review process. ** If appealed within 5 days, permit is stayed for resolution. MM to AA & CUP.doc

COMMUNITY AND ECONONIC DEVELOPMENT DEPARTMENT 2222 M STREET MERCED, CA 95340 PHONE NO. (209) 385-7654/FAX (209) 726-1710 WWW.CO.MERCED.CA.US STAFF USE ONLY DATE SUBMITTED: APPLICATION NO: SUB-TYPE: RELATED APPS: CHECK APPROPRIATE BOX(ES) FOR YOUR APPLICATION TYPE(S): * MAJOR SUBDIVISION PLOT PLAN REVIEW * GENERAL PLAN AMENDMENT * ZONE VARIANCE * MINOR SUBDIVISION ADMINISTRATIVE PERMIT * ZONE CHANGE MODIFICATION * PROPERTY LINE ADJUSTMENT CONDITIONAL USE PERMIT * GEN. PLAN TEXT AMENDMENT * MAJOR DEVIATION REPLAMATION PL AN * ZONE CODE TEXT AMENDMENT *See Page 2 for Required Additional Information Assistance in filling out this application packet will be provided at the Customer Service Counter during regular business hours. ASSESSOR'S PARCEL NUMBER(S) NAME OF PROPERTY OWNER: ADDRESS: PHONE: EMAIL/FAX: CELL: NAME OF APPLICANT / AGENT IF OTHER THAN PROPERTY OWNER: ADDRESS: PHONE: EMAIL/FAX: CELL: ENGINEER: ADDRESS: PHONE: EMAIL/FAX: CELL: (A) BRIEFLY DESCRIBE APPLICATION PROPOSAL: (B) EXPLAIN IN DETAIL THE PROPOSED USE AND DEVELOPMENT OF THE PROPERTY: PLEASE PROVIDE A DETAILED OPERATIONAL ON A SEPARATE SHEET(S) OF PAPER. INDEMNITY AND HOLD HARMLESS AGREEMENT: Applicant has the contracted duty (hereinafter "the duty") to indemnify, defend and hold harmless, County, its Board of Supervisors, commissions, officers, employees, agents and assigns (hereinafter "COUNTY") from and against any and all claims, petitions, demands, liability, judgments, awards, interest, attorney's fees, expert witness and consultant fees and other costs and expenses of whatsoever kind or nature, at any time arising out of or in any way connected with the performance of this Agreement, whether in tort, contract, writ of mandamus, or otherwise. This duty shall include, but not be limited to, claims, petitions, or the like for bodily injury, property damage, personal injury, contractual damages, writ of mandamus, or otherwise alleged to be caused to any person or entity including, but not limited to employees, agents, commissions, boards, and officers of Applicant. Applicant's liability for indemnity under this Agreement shall apply, regardless of fault, to any acts or omissions, willful misconduct, or negligent conduct of any kind, on the part of the Applicant, its employees, subcontractors, agents, and officers. The duty shall extend to any allegation or claim of liability, or petition, except in circumstances found by a jury or judge to be the sole and legal result of the willful misconduct of COUNTY. This duty shall arise at the first notice of filing a lawsuit, claim, petition, or allegation of liability against COUNTY. Applicant will on request and at its expense, defend any action suit or proceeding arising hereunder. This clause and shall not be limited to any claim, petition, demand, liability, judgment, award, interest, attorney's fees, expert or consultant witness fees, legal research fees, staff and administrative costs, administrative record costs, materials, and costs and expenses of whatsoever kind or nature, that may arise during the term of this Agreement, but shall also apply to all such claims and the like, after the term of this contract, including but not limited to actions arising from public interest, land use and environmental legal actions, brought against the COUNTY following PROJECT approval, modification, denial, or the exercise or exhaustion of administrative appeals. Attorney's fees shall include any and all attorneys fees but not be limited to attorneys fees and staff time incurred by the offices of COUNTY counsel. COUNTY shall have full discretion to select legal counsel of its own choosing to represent COUNTY, at a cost not exceeding the prevailing and reasonable rates for counsel practicing environmental and land use law in the State of California, or practicing any other area of law that the COUNTY determines the Claim may reasonably require. This clause for indemnification shall be interpreted to the broadest extent permitted by law. I have read, agree and accept the County Indemnity and Hold Harmless Agreement: SIGNED: APPLICANT There are no deed restrictions on this land that would prohibit this type of use or development. I (We) depose and say that I am the property owner involved in this application and the forgoing statements and answers herein contained and the information herewith submitted are in all respects true and correct to the best of my knowledge and belief. Signed: PROPERTY OWNER DATE PROPERTY OWNER DATE To check the status of your application go to our web site at: http://www.co.merced.ca.us/index.aspx?nid=426 DATE

REQUIRED ADDITIONAL INFORMATION (FOR APPLICATIONS WITH AN *ASTERICK) *MAJOR SUBDIVISION Subdivision Name: Number of Proposed Lots: Average Lot Size: Proposed Use: Proposed Phasing: *MINOR SUBDIVISION *PROPERTY LINE ADJUSTMENT A. Total Area Sq. Ft./Acres of Proposed Parcels: No. 1 Sq. Ft./Acres No. 2 Sq. Ft./Acres No. 3 Sq. Ft./Acres No. 4 Sq. Ft./Acres B. Proposed Services: Public Water System Private Sewer System Public Sewer System Private Water System C. If Approved, will proposed parcels abut a public road right of way Yes No D. Name and Width of Roads Abutting Property: Road: Width: Road: Width: * ZONE VARIANCE (Please attach separate sheets to describe the proposed variance) The landowner must explain below how their application can meet the following findings in accordance with Merced County Zoning Code Title 18, Section 18.50.3.C.2 A. The variance does not authorize a use or activity which is not allowed in the zone: B. Because of physical circumstances such as size, shape, topography and location of surroundings, the strict application of the zoning ordinance deprives such property of privileges enjoyed by other property in the vicinity under identical zoning classification C. The variance shall not constitute a grant of special privileges inconsistent with the limitations upon other properties in the vicinity and zone in which the property is situated: Note: A Zone Variance shall expire within two years unless exercised or extended by the Planning Commission. * MINOR DEVIATION (Please attach separate sheets in response to A and B below) The landowner must explain how their application can meet the following findings in accordance with Merced County Zoning Code Title 18, Section 18.50.C.3 A. The deviation does not grant such property privileges not enjoyed by other properties in the vicinity under identical zoning classification, and B. That the minor deviation is not materially detrimental to surrounding property. Indicate which setback or height limit is proposed to be exceeded and by how many feet: Up to 25 % of front yard setback requirements but not closer than 15 feet from the property line ft Up to 40 % of the side yard setback requirements but not closer than 3 feet from the property line ft Up to 40% of the rear yard setback requirements but not closer than 15 feet from the property line ft Up to 10 % increase in height allowed for buildings and structures ft Note: A Minor Deviation shall expire within two years unless exercised or extended by the Planning Commission. * GENERAL PLAN AMENDMENT (Please attach separate sheets describing the proposed amendment) Proposed Change From: To: If you are proposing a Text Amendment please attach a separate sheet identifying the section and proposed text. Also, Explain how the request complies with the Urban Centered Concept and agricultural land preservation goals of the General Plan? * ZONE CHANGE (Please attach separate sheets describing the proposed zone change) Proposed Change From: To: If you are proposing a Text Amendment please attach a separate sheet identifying the section and proposed text. Also, Explain how the proposed zone change implements the objectives and policies of the General Plan?

COMMUNITY AND ECONOMIC DEVELOPMENT DEPARTMENT Operational Statement An operational statement is required prior to scheduling of the Completeness of your application. An operational statement should be printed on a separate sheet of paper and shall contain the following: 1. Describe the exact nature of the proposal, including all types of uses-sales, processing, manufacturing, storage commercial etc. 2. Detail existing, proposed and future anticipated operations. 3. Give a brief summary of the proposed operating hours and periods of peak use. 4. Estimate the number of people that will be on the site during peak activity use. 5. Provide a vicinity map highlighting truck routes. 6. Explain the proposed method of waste removal and disposal show on plot plan trash receptacle. 7. Explain how the proposed operation related to any nearby uses. 8. Intended use of all structures. 9. Sizes for all buildings proposed. STRIVING FOR EXCELLENCE Operational Statement.doc

Mark J. Hendrickson Director COMMUNITY AND ECONOMIC DEVELOPMENT DEPARTMENT 2222 M Street Merced, CA 95340 (209) 385-7654 (209) 726-1710 Fax www.co.merced.ca.us Equal Opportunity Employer HAZARDOUS WASTE AND SUBSTANCES STATEMENT This form is to determine if 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: NAME OF OWNER: ADDRESS: NAME OF APPLICANT (If different than owner): ADDRESS: ADDRESS OF SITE: Number Street City Zip Code PROJECT SITE ASSESSOR'S PARCEL NUMBER: LOCAL AGENCY: MERCED COUNTY NOT ON LIST SPECIFY LIST: Pursuant to section 65962.5 of the Government Code REGULATORY IDENTIFICATION NO: DATE OF LIST: (See Cover) APPLICANT SIGNATURE: Date STRIVING FOR EXCELLENCE

USE AND PROCESSING OF THE HAZARDOUS WASTE AND SUBSTANCES STATEMENT The California Government Code requires that applicants for all development projects, excluding building permits, must check the Comprehensive Hazardous Waste and Substances Statement list to determine if the site of the proposed project is on the list. This is to be completed as part of the application materials. The purpose of this is to provide information to be verified and used in the environmental review of the project.

Mark J. Hendrickson Director COMMUNITY AND ECONOMIC DEVELOPMENT DEPARTMENT ENVIRONMENTAL INFORMATION FORM CHECKLIST 2222 M Street Merced, CA 95340 (209) 385-7654 (209) 726-1710 Fax www.co.merced.ca.us Equal Opportunity Employer APPLICANT S NAME APN TYPE OF APPLICATION DATE To Applicant: Please address all applicable items specifically. If your application description or plot plan is incomplete, we will return this list to you with complete items as checked ( ) and incomplete items as circled (O). When the first twelve (12) items are determined to be complete, a Planner will review your application prior to accepting fees. In this way, we hope to assist you better in processing your application. CHECKLIST FOR ENVIRONMENTAL INFORMATION FORM: 1. Name / address / telephone of developer / contact person; and, name and address of project with Assessor s Parcel Number. (Items 1-3) 2. Zoning and general plan designation. (Items 4 & 5) 3. Proposed use with permit and application types required. (Items 6 & 7) 4. Federal to city permits required. (Item 8) 5. Project: Site and structure size, additional parking. (Items 9-12) 6. Landscaping and Project scheduling / phasing. (Items 13 & 14) 7. Associated projects and anticipated development. (Item 15) 8. Details for residential, commercial, industrial, and institutional projects. (Items 16-18) 9. Hazardous / toxic wastes. (Item 19) 10. Water, sewage, and storm water run-off figures and systems descriptions and approvals for each. (Items 20 & 21) 11. Solid wastes and disposal method. (Item 22) 12. Additional traffic and roads affected. (Item 23) 13. Earthwork and dust control methods used during construction. ( Items 24) 14. Changes in physical features, ground water, absorption rate, drainage, views, patterns, and scale. (Items 25-32) 15. Changes in housing or housing demand or planned land use? (Items 33 & 34) 16. Significant amounts of solid waste, substantial air emissions, changes in odor, noise, vibration level or glare? (Items 35-40) 17. Project on filled land or slope of 10 percent or more cutting or fill onsite? (Items 41 & 42) 18. Use of potentially hazardous materials? (Item 43) 19. Substantial change in public services, or increased in fuel consumption? (Items 44 & 45) 20. Relationship to other projects? (Item 46) 21. Change in diversity of number of species in area, reduction in agricultural acreage or deterioration of habitats? ( Items 47-49) 22. Project site and surrounding properties in detail, as they existed before this project. (Items 50 & 51) 23. Applicant s signature and date. 24. Other.

COMMUNITY AND ECONOMIC DEVELOPMENT DEPARTMENT ENVIRONMENTAL INFORMATION FORM (To be completed by Applicant and Submitted with Application) GENERAL PROJECT INFORMATION (Please Type or Print Neatly) 1. Name, address, and telephone number of developer or project sponsor: 2. Name, address, and telephone number of person to be contacted concerning this project: 3. Address of project: Assessor's Parcel Number(s): 4. Existing zoning district: 5. Existing land use designation: 6. Proposed use of site (Project for which this form is filed): 7. Indicate the type of permit(s) application(s) to which this form pertains: 8. List and describe any other related permit(s) and other public approvals required for this project, including those required by city, regional, state and federal agencies: PROJECT DESCRIPTION (Attach Additional Sheets as Necessary) Mark J. Hendrickson Director 2222 M Street Merced, CA 95340 (209) 385-7654 (209) 726-1710 Fax www.co.merced.ca.us Equal Opportunity Employer 9. Project Area: Parcel Size: 10. Square footage (structures): S.F.; S.F. (NEW) (EXISTING) Percentage of lot coverage: 11. Number of floors of construction: New Construction: Floors; Ft. High Existing Construction: Floors; Ft. High -------------------------------------------- FOR PLANNING DEPARTMENT USE ONLY ----------------------------------------- Date Received for Review (Use Date Stamp also): By: Application Type and Number: Date Returned for More Information: By: Date Accepted as Complete: By: Fee: $ Receipt Number: 1 FORM111.EIF.doc

PROJECT DESCRIPTION 12. Number of off-street parking spaces: Existing: Spaces; Handicapped: Spaces. Proposed: Spaces; Handicapped: Spaces. Total area of parking lot(s) and parking spaces: Square Feet. 13. School district(s) the project is located in: 14. Describe any proposed landscaping: 15. Describe proposed scheduling/phasing of project: 16. Describe any associated project(s) or incremental development: 17. If residential, include the number of units, schedule of unit sizes, range of sale prices or rents, and type of household size expected. Units; Unit Size(s) Price Range; Household Size(s) 18. If commercial or industrial, indicate the type (neighborhood, city or regionally oriented) square footage of sales area, square footage of storage area, estimated employment per shift, and loading facilities. Type: ; Sales Area: S.F. Storage Area: ; Active Work Area: S.F. Employees: Per Shift; Daily Shifts Loading Area: ; Square Feet: 19. If institutional, indicate its major function, estimated employment per shift, and describe community benefits to be derived from the project: 20. List any hazardous or toxic materials, chemicals, pesticides, flammable liquids, or other similar product used as a part of the operations and storage container sizes (please consult with the Merced County Environmental Health Division and Fire Department): 21. Describe any estimated consumption of water, the estimated sewage, which will be generated, and the estimated amount of storm water run-off during a 10-year storm for 24 hours. Water: Gallons Per Day; Sewage: Gallons Per Day; Storm water: Cubic Feet. 22. Provide a description of proposed water delivery system(s), sewage treatment system(s), drainage system(s) and water flow or storage requirements for fire suppressions. (A can-and-will serve letter from the appropriate sewer and water district, or percolation tests, may be necessary). 2 FORM111.EIF.doc

23. Describe the estimated amount of solid waste (garbage and/or manure), and the method of disposal: Cubic Yards Per Day; Disposed of By: 24. Indicate the estimated amount of traffic, which would result from the project and the roads to which the project would have access: ADTs, (Average Daily Trips); traffic will Access: (Roads) 25. Describe any earthwork (grading) to be done and dust control methods to be used during construction and for proposed access roads. Cubic yards of cut; cubic yards of fill. Cubic yards of earth material to be removed from the site. Dust Control Measures: ARE THE FOLLOWING ITEMS APPLICABLE TO THE PROJECT OR ITS EFFECTS? DISCUSS BELOW, IN DETAIL, ALL ITEMS CHECKED YES OR MAYBE. YOUR ANSWERS TO THESE QUESTIONS MAY BE DIFFERENT FROM THE COUNTY'S. THEREFORE, PROVIDE EVIDENCE OR DOCUMENTATION TO SUPPORT YOUR STATEMENTS. (Attach Additional Sheets As Necessary). Yes Maybe No 26. Change in existing features of any vegetation, lakes, streams, rivers or hills, or substantial alteration of ground contours. 27. Any change in quantity, direction or flow rate of groundwater? 28. Change in lake, stream, or groundwater quality, quantity and/or alteration of existing drainage patterns. 29. Changes in absorption rates, drainage patterns, or the rate and amount of surface runoff? 30. Discharge into any surface water, or any alteration of surface water quality, i.e., temperature, dissolved oxygen, turbidity, etc.? 31. Change in amount of surface water in any water body? 32. Change in scenic views or vistas from existing residential areas, public lands or roads? 33. Change in pattern, scale or character of the general area of the project? 34. Will the project affect existing housing or create a demand for additional housing? 35. Will the project result in a substantial alteration of the present or planned land use of the area? 36. Significant amounts of solid waste (garbage or manure) or litter? 37. Substantial air emissions or deterioration of ambient air quality? 38. Change in dust, ash, smoke, fumes or odors in the vicinity? 39. Creation of objectionable odors? 3 FORM111.EIF.doc

40. Change in existing noise or vibration levels in the vicinity, or exposure of people to major noise sources (railroad, aircraft, highways, etc.). 41. Will the project produce new light or glare? 42. Site on filled land or on slope of 10 percent or more? 43. Substantial disruptions, displacements, compaction or over covering of soil? 44. Any use of disposable or potentially hazardous materials, such as toxic substances, flammables or explosives. 45. Substantial change in demand for municipal services (police, fire, water, sewage treatment, maintenance, etc.)? 46. Substantially increase fossil fuel consumption (electricity, oil, natural gas, etc.)? 47. Relationship to a larger project or series of projects? 48. Any change in diversity of species, or number of species (plants or animals)? 49. Reduce the amount of acreage of any agricultural crop? 50. Will the project cause deterioration to existing wildlife or fish habitat? ENVIRONMENTAL SETTING (Attach Additional Sheets as Necessary) 51. Describe in detail the project site as it exists before the project, including information on topography, soil stability, soil classifications, soil Storie Index rating(s), plants and animals (wetlands, if any), different crops, irrigation systems, streams, creeks, rivers, canals, water table depth, utilities available, and any cultural, historical or scenic aspects. Attach photographs of the site. 52. 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, agricultural, etc.), intensity of land use (one-family, apartment houses, shops, dairy, row crops, orchards, etc.), and scale of development for residential, commercial, industrial or institutional projects (height, frontage, set-backs, etc.). Attach photographs of the vicinity. 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 (Note: This is only an initial environmental information form; other information may be requested as necessary). 4 FORM111.EIF.doc

Mark J. Hendrickson Director COMMUNITY AND ECONOMIC DEVELOPMENT DEPARTMENT 2222 M Street Merced, CA 95340 (209) 385-7654 (209) 726-1710 Fax www.co.merced.ca.us Equal Opportunity Employer ACKNOWLEDGEMENT OF MAINTAINING EXISTING SITE CONDITIONS Application: APN: As the Property Owner, I hereby acknowledge that until the final approval of the above application by the County of Merced, no work will be performed such as grading or land leveling, land clearing, construction, trenching, or other work that would alter the existing conditions of the project site. I understand that if the project site is altered prior to project approval, the review of the project by the County will be more difficult and potentially expensive and that additional mitigation measures and/or conditions of approval may be imposed. Further, unauthorized work may cause enforcement by other agencies and/or the denial of the application. I have also instructed my agent and/or the project applicant of the importance of maintaining existing site conditions. Exception to the above may be approved by the Planning Department upon a written request. Signed Date STRIVING FOR EXCELLENCE

Mark J. Hendrickson Director COMMUNITY AND ECONOMIC DEVELOPMENT DEPARTMENT 2222 M Street Merced, CA 95340 (209) 385-7654 (209) 726-1710 Fax www.co.merced.ca.us Equal Opportunity Employer ENVIRONMENTAL EVALUATION STANDARDS LAND USE GENERATION FACTORS WEEKDAY SELECTED TRIP END GENERATION RATES ASSUMING 100% OCCUPANCY (FROM TRIP GENERATION MANUAL, 5 TH EDITION) Single Family Patio Homes / Duplexes Townhouses Condominiums Apartments Mobile Homes Retirement Communities Motel Fast Food Restaurant Specialty Retail Center` Sit-down Restaurant Single Tenant Office Building Elementary School High School Churches Light Industry Mini Warehouse 9.5 trips / DU 9.5 trips / DU 5.9 trips / DU 5.9 trips / DU 6.5 trips / DU 4.8 trips / DU 3.3 trips / DU 10.2 trips / room 632 / trips / 1000 sq. ft. building area with drive thru 40.7 trips / 1000 sq. ft. building area 205 trips / 1000 sq. ft. building area 11.5 trips / 1000 sq. ft. building area 1.1 trips per student 1.4 trips per student 9.3 trips / 1000 sq. ft. building area 7 trips / 1000 sq. ft. building area 2.6 trips / 1000 sq. ft. building area ESTIMATED WATER CONSUMPTION RATES (GALLONS / DAY) (FROM CITY OF MERCED AND VARIOUS WATER DISTRICTS WITHIN MERCED COUNTY) Single Family Residential 606 / DU / metered or 1000 / DU / not metered or 190 / resident (includes landscaping) STRIVING FOR EXCELLENCE Land Use Generation Factors.doc

Multi Family Residential Offices 240 / DU or 125 / resident 120 gallons / day / 1000 sq. ft. floor area Retail Commercial 120 gallons / day / 1000 sq. ft. floor area or 2000 gallons / acre / day Other Land Uses Estimate amount ESTIMATED SEWAGE GENERATION RATES (GALLONS / DAY) (FROM CITY OF MERCED) Single - Family Residential Multi - Family Residential Commercial Office Industrial 354 gallons / DU or 111 gallons / day / resident 213 gallons / DU or 111 gallons / day / resident 108 gallons / day / 1000 sq. ft. floor area 108 gallons / day / 1000 sq. ft. floor area Variable - Please describe the sewage requirements for any industrial uses in your project. (General projection = 2500 gallons / day / acre. ESTIMATED SOLID WASTE GENERATION RATES (POUNDS / DAY) (FROM COUNTY SOLID WASTE DIVISION AND CITY OF MERCED) Single - Family Residential Multi - Family Residential Retail Commercial Industrial / Heavy Commercial Poultry or Dairy 11.2 / DU 5.3 / DU 21 lbs / 550 sq. ft. area Variable - Please describe the projected solid waste to be generated by your project. Please consult with the Environmental Health Division (209) 381-1100. POPULATION PER HOUSEHOLD = 3.3 (FROM STATE DEPARTMENT OF FINANCE, 1990) NOTE: IF YOU HAVE INFORMATION THAT DIFFERS WITH THESE STANDARDS, PLEASE PROVIDE US WITH YOUR FIGURES AND THE SOURCE OF YOUR INFORMATION. THANK YOU! Land Use Generation Factors.doc

COMMUNITY AND ECONOMIC DEVELOPMENT DEPARTMENT PLOT PLAN CHECKLIST APPLICANT S NAME A.P.N. # *TYPE OF APPLICATION DATE TO APPLICANT: Please address all items that are applicable. If your application description or plot plan is incomplete, we will return this list to you with complete items as checked ( ) and incomplete items as circled ( O ). When the Planning Department determines that your plot plan complies with this checklist and all other required items have been received, a letter will be mailed or given to you acknowledging receipt of your application. It will then be assigned to a Planner who will review it to determine whether or not the entire application is complete for acceptance of fees and processing. If you have any questions, on this checklist or at anytime during the processing of your application, please call the Planning Department at (209) 385-7654. PLOT PLAN CHECKLIST* (see attached example) 1. Size of drawing shall be maximum of 11in. x 17in., legible and be of reproducible quality. 2. North is to be at the top of the page unless parcel shape dictates otherwise. Indicate direction with North arrow and draw to an easily measured bar scale; for example, 1 inch = 20 feet or 200 feet. (North arrow and bar scale printed on plot plan). 3. Name, address, and zip code of Property Owner, Assessor s Parcel Number, and date. 4. Name, address, zip code and telephone number of Draftsman or Engineer. 5. Show streets bordering property and closest if not on a corner. Indicate width of streets and label by full name and type (Road, Street, Lane, Boulevard, Etc) 6. Identify adjacent land uses and distances to any dwellings within 500 feet of subject property. 7. Show noise and flood zone contours, if applicable. (The Planning Department has maps and other information related to these items) 8. Show, identify, and dimension all rights-of-way and / or easements. (Including roads, natural and man-made water courses, etc.) 9. Show entrances to, and exits from property, and dimensions of driveways. 10. Dimension entire property, showing parcels and lots where applicable, and showing size of property / parcels / lots in acres or square feet. 11. Locate, identify and dimension all existing and proposed buildings and uses such as: parking fences, trash enclosures, outside lighting, screening and landscaping. Indicate percent of lot coverage by buildings. STRIVING FOR EXCELLENCE Form 401 plot plan list.doc

12. Indicate distances between buildings and distances to closest side, rear, and front lot lines. 13. Indicate who will be living in the existing and proposed dwellings on the property (owner, owner s family, agricultural employees, etc.) 14. Show proposed landscaping and irrigation systems on a separate plan, if applicable. 15. Show detailed drawing of floor plans, with elevations to scale and identify exterior materials for all proposed buildings in applications for conditional use permits in urban areas and in applications for multiple-family residential projects. 16. Show number of parking spaces, dimensions, and square footage of parking area and type of surfacing proposed. (Parking requirements can be determined by referring to Chapter 18.168 of the County Zoning Code) 17. Show elevation contours and proposed finished grades if appropriate. (Elevation contours are shown on U.S.G.S. 7 ½ Minute Quadrangle (Topographic Maps) 18. Show drainage plan location, direction of flow and final disposal, if applicable. 19. Show location and dimension of all existing or proposed signs. Indicate on a detailed drawing the size, height aboveground if free standing, and what will be on the face of the sign(s). Also, indicate if the sign(s) will be illuminated and how. 20. Locate by dimension all existing and / or proposed water wells and septic systems. ** 21. Indicate uses to be brought into conformance with the Building or Zoning Codes (buildings, areas, etc.) with this application. * Subdivision Applications and those with Animal Confinement Facilities use a different checklist. ** The County Environmental Health Division must approve all septic systems. Where a project is to be located within a Specific Urban Development Plan (SUDP) of an unincorporated community, which is served by a local urban utility district for sewer and water, a Can-and-Will-Serve letter shall be provided from the district. Form 401 plot plan list.doc