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CITY OF MODESTO Community and Economic Development Department/Planning Division 1010 Tenth Street, Suite 3300, P.O. Box 642 Modesto, CA 95353 (209) 577-5267 (209) 491-5798 FAX Updated June 25, 2020 Uniform Application Note: In order for Applications to be deemed complete under Section 65943 of the Government Code, the following items must be provided: 1. Completed Uniform Application 2. Completed Environmental Information Form if applicable 3. Completed Financial interest Disclosure form if applicable 4. Development Plans as required by Submittal Requirements – http://modestogov.com/1561/Planning-Forms-and-Applications 5. Appropriate Filing Fee - http://modestogov.com/1561/Planning-Forms-and-Applications GENERAL REQUIREMENTS (Print or Type) Property Owner: (staff use only) Address: File No.: Home Telephone No.: Work/Cell No: Trak-it Case No.: E-mail Address: Fax No.: Date: Applicant: Rec’d by: Address: Home Telephone No.: Work/Cell No: E-mail Address: Fax No.: Applicant’s Representative: Address: Telephone No.: Fax No.: E-Mail Address: Note: If the applicant is not the property owner, the property owner shall designate the applicant as the authorized agent to act on his or her behalf and both shall sign this application. TYPE OF APPLICATION (check all that apply) Annexation 1 Mills Act Contract Rezone Conditional Use Permit P-D Zone Amendment 4 Specific Plan 5 Development Agreement P-D Zone Amendment 3 Specific Plan Amendment 5 Final Development Plan Planned Development Zone Street or Alley Abandonment General Plan Amendment 2 Precise Plan Tentative Parcel Map Historic Alteration or Demolition Precise Plan Amendment Tentative Subdivision Map Landmark Designation Removal from Eligible Properties List Variance 6 1 Refer to Supplemental Checklist for Annexation Applications 2Refer to Section II.C.4 of the Modesto Urban Area General Plan regarding General Plan Amendment procedures 3 Pursuant to Section 10-7.108 Amendment involves changes in conditions of approval or site redesign 4 Pursuant to Section 10-7.108 Amendment involves change in use or significant site redesign 5Refer to Specific Plan Procedures & Preparation Guide regarding Specific Plan submittal requirements 6Refer to Supplemental Questionnaire for Variance Applications ---PAGE BREAK--- City of Modesto Uniform Application Page 2 of 5 Updated June 25, 2020 PROJECT DESCRIPTION (attach additional sheets if necessary) Description and purpose of proposal: Address or Location of Property: Assessor’s Parcel Number(s): Current Zoning: Proposed Zoning (if applicable): Current General Plan Designation: Proposed General Plan Designation (if applicable): Existing Use of Property: Description of Surrounding Uses: ---PAGE BREAK--- City of Modesto Uniform Application Page 3 of 5 Updated June 25, 2020 NON-RESIDENTIAL PROJECTS OFFICE/RETAIL/INDUSTRIAL/INSTITUTIONAL PROJECT SUMMARY TABLE SITE AREA DISTRIBUTION Site Area: Gross acres: Net acres: Proposed Phasing: Building Area: Existing Structures: sq. ft. New Structures: sq. ft. Height: ft. Number of Floors: For Commercial Developments: Market/service area: Professional Office Medical Office Retail/Restaurant Square footage: For Industrial Developments: Use: Warehouse/distribution Manufacturing Multi-tenant Other Square footage: Estimated employees per shift: For Institutional Developments: Use/function: Estimated employees per shift: Estimated number of occupants: PARKING Type of Use Parking Ratio # Spaces Required # Spaces Provided TOTALS Attach separate sheet(s) if necessary to provide complete Land Use/Unit/Density/Area/Parking breakdown. ---PAGE BREAK--- City of Modesto Uniform Application Page 4 of 5 Updated June 25, 2020 RESIDENTIAL PROJECT SUMMARY TABLE (if applicable) PROJECT AREA Site Area: Gross acres: Net acres: No. Phases: DWELLING UNITS (based on net acres) Number Net Density Single Family Detached Single Family Attached Multi-Family/Condominium Studio One Bedroom Two Bedroom Three Bedroom Four or more Bedrooms TOTAL AREA DISTRIBUTION (based on net area) Acres/Sq. ft. % of Net Area Building Coverage Common Open Space Private Open Space (per unit) N/A PARKING Parking Ratio # of Units Spaces Req’d Spaces Provided Single-Family Detached Single-Family Attached Multi-family/Condominium TOTAL Attach separate sheet(s) if necessary to provide complete Land Use/Unit/Density/Area/Parking breakdown. ---PAGE BREAK--- City of Modesto Uniform Application Page 5 of 5 Updated June 25, 2020 PROJECT LOCATION LETTER OF AUTHORIZATION PROJECT LOCATION General Location/Address of Project: Assessor’s Parcel No(s): Precise Legal Description (Attach. Required for the following : Rezoning, Annexation, Street or Alley Abandonment): AFFIDAVIT If property owner is a trust, partnership, LLC, the signature shall be a corporate officer. Attach additional sheets if necessary. I, hereby certify that I am the applicant in the foregoing application, that I have read the foregoing application and know the content thereof and state that the same is true and correct to the best of my knowledge. Applicant (signature) Applicant (print name) I, hereby certify that I am the owner (if other than the applicant) of real property involved in this application, do hereby consent to the filing of this application. Attach separate sheets if multiple property owners. Owner (signature) Owner (print name) In accordance with the requirements of Title II of the Americans with Disabilities Act (“ADA”) of 1990, the Fair Employment & Housing Act (“FEHA”), the Rehabilitation Act of 1973 (as amended), Government Code section 11135 and other applicable codes, the City of Modesto (“City”) will not discriminate against individuals on the basis of disability in the City’s services, programs, or activities. For more information, please visit the City of Modesto website: The property owner and developer shall, at their sole expense, defend, indemnify and hold harmless the City of Modesto, its agents, officers, directors and employees, from and against all claims, actions, damages, losses, or expenses of every type and description, including but not limited to payment of attorneys’ fees and costs, by reason of, or arising out of, this development approval. The obligation to defend, indemnify and hold harmless shall include but is not limited to any action to arbitrate, attack, review, set aside, void or annul this development approval on any grounds whatsoever. The City of Modesto shall notify the developer of any such claim, action, or proceeding and shall cooperate fully in the defense.