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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 August 20, 2012 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://www.modestogov.com/ced/forms/planning.asp 5. Appropriate Filing Fee - http://www.modestogov.com/ced/forms/fees.asp GENERAL REQUIREMENTS (Print or Type) Property Owner: (staff use only) Address: File No.: Home Telephone No.: Work/Cell No: Tidemark 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 Precise Plan Variance 6 Conditional Use Permit Precise Plan Amendment Other: Development Agreement Rezone Final Development Plan Specific Plan 5 General Plan Amendment 2 Specific Plan Amendment 5 P-D Zone Amendment 3 Street or Alley Abandonment P-D Zone Amendment 4 Tentative Parcel Map Planned Development Zone Tentative Subdivision Map 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 August 20, 2012 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 August 20, 2012 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: sq. 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 August 20, 2012 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 August 20, 2012 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) ---PAGE BREAK--- 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 August 20, 2012 Addendum to Uniform Application Form California Military Land Use Compatibility Analyst (CMLUCA) Senate Bill 1462 California State Law requires that applicants identify whether or not a proposed project is located within 1,000 feet of a military installation. A website, CMLUCA, is available to provide this information at http://sample1.casil.ucdavis.edu/Calmap8/. Projects meeting this criteria will be referred to the United States military for comment and coordination. For all projects identified by CMLUCA as meeting the criteria, attach a print of the CMLUCA form. FORM: The undersigned owner(s), applicant(s) or their legal representative(s) of the lands for which this development project application is made, hereby certify under penalty of perjury under the laws of the State of California that: a. Is not located on a site within the area requiring military notification as identified by CMLUCA, dated . b. Is located on a site within the area requiring military notification as identified by CMLUCA, dated . List Assessor’s Parcel Numbers of the project property. Signatures of Applicants/Owners of Record Date Attach additional sheets if necessary