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Updated 3/21 APPLICATION FOR: MINOR EXCEPTION (Section 23.03) MINOR MODIFICATION (Section 26.04) Planning Division Case No.: 38250 Sierra Highway Palmdale, CA 93550 Date: (661) 267-5200 [EMAIL REDACTED] Received by: Print Name SUBMITTAL REQUIREMENTS 1. Submit four copies of plans showing clearly what modification(s) or exception(s) are proposed. Single family modification plot plans may show “existing” and “proposed” structures for such revisions as additions to the main structure, guest houses, patios, gazebos, and playhouses. 2. Minor Modifications Only: a. Submit one copy of the original stamped approved plans with all revisions highlighted by clouding or other means so that staff can quickly identify where changes are occurring. b. Minor modification plans should be labeled with original case number. In the case of Subdivision Development Plan (SDP) modifications or exceptions, plans should conform to the requirements for SDP approval. Project Location (Address if Available): Approximately feet N or S of (Circle) (Street Name) Approximately feet E or W of (Circle) (Street Name) Assessor’s Parcel Number(s): *APPLICANT: Name and Email Address: Address: City: State: Zip: Telephone No.: ( ) Fax No.: ( ) CONTACT PERSON: Name and Email Address: Address: City: State: Zip: Telephone No.: ( ) Fax No.: ( ) OWNER: Name and Email Address: Address: City: State: Zip: Telephone No.: ( ) Fax No.: ( ) ARCHITECT/ENGINEER/REPRESENTATIVE: Name and Email Address: Address: City: State: Zip: Telephone No.: ( ) Fax No.: ( ) *If applicant is different from the property owner, please have the property owner sign the bottom of page 2. ---PAGE BREAK--- Updated 3/21 Fee Calculation for Minor Exception: Base fee (contact Planning staff) $450.00 City of Palmdale Fish and Wildlife Processing Fee: 25.00 @ $1.65 / label (if applicable): # of labels **Post Approval Plan Check ($600 per plan / maximum of $2,400): GIS Fee 5% of – Round to nearest dollar: 23.00 TOTAL FEE DUE: Fee Calculation for Minor Modification: Base fee (contact Planning staff) $300.00 City of Palmdale Fish and Wildlife Processing Fee: 25.00 @ $1.65 / label (if applicable): # of labels **Post Approval Plan Check ($600 per plan / maximum of $2,400): GIS Fee 5% of – Round to nearest dollar: 15.00 TOTAL FEE DUE: **Please note that a Post Approval Plan Check fee is required to be assessed prior to sign off by the Planning Division for permit issuance. Payment may be made at the time of application submittal or during plan check for the project. ---PAGE BREAK--- Updated 3/21 DESCRIBE MODIFICATION(S) OR EXCEPTION(S) IN DETAIL. PLEASE BE AS SPECIFIC AS POSSIBLE, DESCRIBING LOCATIONS AND DIMENSIONS. INCLUDE JUSTIFICATION FOR GRANTING A MINOR EXCEPTION BASED ON THE REQUIRED FINDINGS LISTED IN SECTION 23.06.C.1-4 OF THE ZONING ORDINANCE IF APPLICABLE. INCLUDE ANY INFORMATION YOU BELIEVE WILL ASSIST THE CITY IN REVIEWING YOUR APPLICATION. USE ADDITIONAL SHEETS IF NECESSARY. IF THIS APPLICATION IS TO MODIFY A WIRELESS TELECOMMUNICATION FACILITY, YOU MUST INCLUDE THE ORIGINAL “CONDITIONAL USE PERMIT” NUMBER ON THE PLANS AND ON APPLICATION AS WELL AS A COPY OF THE CONDITIONS OF APPROVAL. IF THE ORIGINAL APPROVAL WAS UNDER AN “ADMINISTRATIVE APPROVAL” (MINOR MODIFICATION), PLEASE INCLUDE THAT APPROVAL NUMBER ON THE PLANS AND THE APPLICATION. Signature Date ---PAGE BREAK--- Updated 3/21 OWNER AUTHORIZATION LETTER CASE NUMBER(S): ASSESSOR’S PARCEL NUMBER(S): If the applicant is not the owner of record, then a letter authorizing the applicant to represent the owner(s) must be submitted. Note: All owners must sign as their names appear on the deed to the land. This letter shall serve to notify and verify that I/we am/are the legal owners of the property described and attached hereto and do hereby authorize the applicant to file and represent my/our interest in the above referenced applications(s). I/we have read this Letter of Authorization and know the contents thereof; and so hereby certify (or declare) under penalty of perjury under the laws of the State of California that the information contained in the above referenced application(s) is true and correct. OWNER(S) OF RECORD (Include extra sheets if necessary): Printed Name Signature Date Printed Name Signature Date I certify under penalty of perjury that I am the applicant and that the foregoing statements and answers herein contained and the information herein submitted, are in all respects true and correct. APPLICANT / APPLICANT’S REPRESENTATIVE: Printed Name Signature Date Address (including City and State) Telephone Printed Name Signature Date Address (including City and State) Telephone SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF NOTARY PUBLIC NOTE: ATTACH LEGAL DESCRIPTION OF PROPERTY TO THIS DOCUMENT. ---PAGE BREAK--- 3/21 PLAN PREPARATION GUIDELINES Plans must be prepared accurately by a qualified individual registered civil engineer, licensed architect, licensed building designer), drawn to a standard engineering scale 1 inch = 20 feet, 1 inch = 50 feet, 1 inch =100 feet, 1 inch = 200 feet) or architectural scale ¼ inch = 1 feet, 1/8 inch = 1 inch) that is appropriate to the project size and able to clearly define and identify all required information, and include the following: A. SITE PLANS: 1. Title Block containing: a. Name, address, and phone number of developer and/or owner. b. Name, address, phone number, license number, expiration date, and stamp of the person preparing the plans. c. Address of project. 2. Legend containing: a. The Assessor’s Parcel Number (APN). b. Scale. c. A legal description of the property sufficient to locate the property. d. Existing and proposed zoning and General Plan designations. e. Date of plan preparation with revision date plate. f. Statement indicating current and proposed land use. g. Statement indicating gross and net acreage (after dedications) of property. h. Gross square footage of structure(s) (existing and proposed) including a breakdown of net leasable floor area and linear and square footage of seating (if applicable); indicate estimated square footage proposed for each different use within the structure(s); and density analysis (residential only). i. Lot coverage (area of site covered by structures) expressed as percentage of site or Floor Area Ratio (if applicable). j. Square footage of landscaping, existing and proposed, with dimensions and amount of landscaped area expressed as a percentage of the entire site, and a percentage of the interior parking area (i.e. exclude landscaping located within the required setback areas). k. Number of parking spaces required and provided (breakdown by proposed uses, if more than one, and show calculations for each); list separately the number of covered, handicapped, uncovered, compact, bicycle, and loading zone spaces provided. l. Type of building construction. m. Type of building occupancy and number of employees. 3. Plot Plan Showing: a. North-arrow. ---PAGE BREAK--- 3/21 b. Boundaries - Existing and proposed lot lines, numbers, and areas. c. Easements - Locations, dimensions, and type of all easements. d. Grades - Existing and proposed including building pad elevations, streets, adjacent grades within 100 feet of project boundary; show by contours at adequate intervals. e. Structures - Locations, footprints, dimensions, distances between structures and property lines and use of existing and proposed structures within the project. Show open stairways and other projections from exterior buildings walls, including entrances and exits, and handicap ramps. f. Fences and Walls - Location, elevation, height, and composition of all existing and proposed walls and fences. g. Yards - Distance between exterior walls of structures and other such walls and property lines. Indicate location of any dedicated yards. h. Circulation/Parking - Completely dimensioned layout of internal driveways, aisles, parking stalls, loading spaces, vehicle ingress and egress to site, sidewalks or other pedestrian walkways, and handicapped access for the site conforming to Title 24 of the California Building Code. Include appropriate required markings for handicap parking and loading zones. Identify and give direction of all one-way aisles. i. Streets - Location and cross-sections of existing and proposed rights-of-way, enriched parkways, left turn lanes, improvements (sidewalks, curbs, gutters, driveways, and landscaping), completely dimensioned (on-site and off-site). j. Drainage Facilities - Location, type, and size (on-site and off-site). Show how the project will handle storm water and cross drainage to or from adjacent properties. k. Lighting - Location and size of all exterior lighting standards and devices. l. Refuse - Location of refuse disposal areas. m. Storage - Location of outside storage areas and indication of screening method. n. Utilities - Location, size, and dimensions of all existing and proposed underground and above ground utilities and equipment (on-site and off-site). Provide name, address, and phone number of all affected utilities. Show proposed screening of electrical transformer and Water District backflow device. o. Sign Location - Location of all existing and proposed free-standing signs. p. Trees - Location, existing grade, circumference, and species of all existing trees on site (may require a separate tree report). q. Adjacent Uses - All existing uses, structures, walls, fences, yards, drainage facilities, lighting, signs, parking, driveways, trees, and grades within 100 feet of the project boundary. ---PAGE BREAK--- 3/21 r. Barriers - Location and dimensions of all wheel/bumper stops and concrete headers separating vehicular areas from landscaped areas. 4. Vicinity Map: A vicinity map of the project site depicting adjoining projects, creeks, railroads, major cross streets, landmarks and other data sufficient to locate the proposed project in relationship to the surrounding community. B. BUILDING ELEVATIONS: 1. All pertinent horizontal and vertical dimensions of existing and proposed structures. Height measurements shall be made from grade to the highest point of construction. 2. Architectural elevations of each side (i.e. front, rear, and sides) of each building or structure type: a. Show rooftop equipment and demonstrate parapet screening (identify screening material). b. Show adjacent structures on street elevation. c. Include a composite elevation from street level if multiple buildings are proposed (incorporate the profile of landscaping and structures or equipment adjacent to such elevations). d. Label each elevation with a directional (north, south, etc.) orientation. 3. Type of roof, window, and wall materials (finished surface) to be used. 4. Accurate color rendering of structure (1 copy of typical elevation or perspective rendered in accurate color). 5. Location(s) and dimensions for all sign, graphics, or other advertising displays proposed on-site; indicate type, color, copy (if known) and materials of construction. (NOTE: If a separate sign plan is required for this project, make sure that the information contained in both is the same). 6. Roof plan showing the direction of roof elements and equipment, exterior lights, vents, ducts, and other exterior mechanical utility equipment. ---PAGE BREAK--- 3/21 C. FLOOR PLANS: 1. All room and area dimensions including existing rooms/areas adjacent to the proposed construction and overall dimensions. 2. The proposed use of all rooms and areas identified and the amount of gross floor area for each proposed use. 3. Occupant load calculations and Occupancy Classification for each room or area and the entire structure. 4. Provisions for accessibility to the elderly and physically disabled which are required by law for buildings and facilities to be used by the public (consistent with Title 24 of the California Building Code). 5. Statement indicating whether or not automatic fire sprinkler systems will be used in the structure.