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12/20 APPLICATION FOR VARIANCE Planning Division Case 38250 Sierra Highway Palmdale, CA 93550 (661) 267-5200 [EMAIL REDACTED] Received Print Name INSTRUCTIONS TO APPLICANT The following application form is provided for all applicants requesting a variance from the City of Palmdale. The applicant must complete the attached form as prescribed and submit the following information before the application can be accepted by the Planning Division. VARIANCE SUBMITTAL CHECKLIST (ALL PLANS MUST BE FOLDED BY THE APPLICANT TO A MAXIMUM 8½” x 11” SIZE) The completed Application A copy of the Development Advisory Board (DAB) letter (if applicable) Three copies of the Title Report for the subject property prepared within the last six months which includes a declaration of all easements of record and copies of all easement/declaration instruments referenced. Note: Preliminary Subdivision Reports are not acceptable. Two sets of property owner (including APN) and occupant mailing labels (self-sticking) for all properties within 500 / 700 / 1,000 feet of the subject property (see attached requirements) A copy of the mailing list in tabular form containing all the information on the above labels (see attached requirements) One radius map (see attached requirements) The original Mailing Label Certification The original and two copies of the Owner Authorization Letter Two paper copies and an electronic copy of the legal description of the property The original and two copies of the Hazardous Materials/Waste Products Certification 20 copies of the variance justification letter (see attached requirements) ---PAGE BREAK--- 12/20 A vicinity map at a scale clearly indicating the subject parcel(s) and showing the existing major street patterns, adjoining projects, subdivision(s), creeks, railroads and other significant landmarks within a minimum of one mile of the exterior boundaries of the site on 8½” x 11” paper. Note: Thomas Guide maps are not acceptable. 20 copies of the site plan or other applicable plan (see attached requirements) 10 copies of the elevation drawings for all structures, showing all sides (if applicable). One copy of the elevations shall be rendered to indicate color and material selections. The original Public Hearing Sign Removal Authorization. Complete Fire Department Transmittal Letter (attached). Once case number is supplied, submit this form to project’s online submittal with the Los Angeles County Fire Department through the EPIC-LA permitting system. Pursuant to the California Environmental Quality Act, the Planning Division will review the project and determine areas of potential environmental impact. Special studies including, but not limited to, traffic, biological, noise and archaeological may be required. This information may also be obtained through preliminary project review by the Development Advisory Board (DAB). FEE CALCULATIONS* Base Fee: $ 1,750.00 Initial Environmental Study: 950.00 City of Palmdale Fish and Wildlife Processing Fee: 25.00 @ $1.65 / label: # of labels Public Hearing Notice: 300.00 GIS Fee 5% of Base Fee: TOTAL FEE RECEIVED: **Additional State and/or County fees may be required prior to project approval. If you have any questions regarding this application packet or required materials, please call the Planning Division. ---PAGE BREAK--- 12/20 Variance No.: Was a Pre-Application filed? Yes No If yes, reference DAB: If proposed Variance is located within an existing tract or building, please list Tract and Lot, and all Planning Division reference(s): List all other applications being filed with this project: Project Location (Address if Available): Approximately Feet N or S of (Circle) (Street Name) Approximately Feet E or W of (Circle) (Street Name) Property Size (acres): Describe Zone Variance Request (include total acres of property affected). Existing Zoning: Existing General Plan Designation: Assessor’s Parcel Number(s): APPLICANT: Name/Email: Address: City: State: Zip: Telephone No.: ( ) Fax No.: ( ) OWNER: Name/Email: Address: City: State: Zip: Telephone No.: ( ) Fax No.: ( ) ENGINEER/REPRESENTATIVE: Name/Email: Address: City: State: Zip: Telephone No.: ( ) Fax No.: ( ) Use additional sheets in the case of multiple parcel numbers, owners, etc. Please include in mailing list all other persons to be notified regarding this application. ---PAGE BREAK--- 12/20 APPLICANT’S JUSTIFICATION FOR VARIANCE - On a separate sheet of paper, provide your explanations and justification to support the following respective findings as required by the Palmdale Municipal Code (PMC) Section 17.23.060.C: 1. There are special circumstances applicable to the property, including size, shape, topography, location or surroundings, so that the strict application of the PMC would deprive such property of privileges enjoyed by other properties in the vicinity and under identical land use district classification; 2. Granting the Variance is necessary for the preservation and enjoyment of a substantial property right possessed by other properties in the same vicinity and land use district and denied to the property for which the Variance is sought; 3. Granting the Variance will not be materially detrimental to the public health, safety, or welfare, or injurious to the properties or improvements in such vicinity and land use district in which the property is located; and 4. Granting the Variance does not constitute a special privilege inconsistent with the limitations upon other properties in the vicinity and land use district in which such property is located. Please attach any additional information or explanations that you consider relevant to your request. ---PAGE BREAK--- 12/20 CITY OF PALMDALE PLANNING DIVISION 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 Telephone Printed Name Signature Date Address Telephone SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF NOTARY PUBLIC ---PAGE BREAK--- 12/20 NOTE: ATTACH LEGAL DESCRIPTION OF PROPERTY TO THIS DOCUMENT. ---PAGE BREAK--- 12/20 CITY OF PALMDALE PLANNING DIVISION HAZARDOUS MATERIALS / WASTE PRODUCTS CERTIFICATION Pursuant to Section 65962.5(f) of State Government Code, project applicants must identify whether a project site contains any hazardous materials and/or wastes included on any list compiled by the State Department of Health Services, the State Water Resources Control Board or the California Integrated Waste Management Board or are known by the owner or applicant. These lists generally identify sites that have pending corrective action regarding leaks or migration of hazardous materials. CERTIFICATION I have consulted the list compiled pursuant to Section 65962.5 of the Government Code and hereby certify that the project site and any alternatives to the project are are not identified on any of these lists. I further certify that, to the best of my knowledge, there are are not such hazardous materials on this site. Assessor’s Parcel Number(s): Case Number(s): Project Location (address if available): Approximately Feet N or S of (Circle) (Street Name) Approximately Feet E or W of (Circle) (Street Name) Use additional sheets if necessary. Date Owner’s Signature Date Owner’s Signature Date Applicant’s Signature If the site is listed, which listing agency has identified the site? If the site is listed, what is the Regulatory Identification Number associated with the site? NOTE: Before the Lead Agency can accept the application as complete, this certification must be reviewed and signed by the project owner(s) and applicant. ---PAGE BREAK--- 12/20 CITY OF PALMDALE PLANNING DIVISION MAILING LABEL CERTIFICATION CASE NUMBER(S): I certify under the penalty of perjury that on the day of the attached property owners list contains the names and addresses of persons to whom property is assessed as they appear on the latest available equalized assessment roll of the County of Los Angeles within the subject property and for the parcels within 500 feet of the boundary of the subject property. PLEASE PRINT ALL INFORMATION EXCEPT SIGNATURE. Name: Title: Company: Address: Phone: ( ) Signature: Date: ---PAGE BREAK--- 12/20 LEAVE THIS AREA BLANK Applicant’s Name Address City, State, Zip Code THIS FORM MUST BE USED TO CREATE MAILING LABELS. Use the following format: Owner’s Name Address City, State, Zip Code Assessor’s Parcel No. Name Address City, State, Zip Code Representative / Engineer Name Address City, State, Zip Code ---PAGE BREAK--- -10- CITY OF PALMDALE PLANNING DIVISION PROCEDURES FOR PROJECT SITE SIGN POSTING In order to increase public awareness of pending development proposals requiring public hearings, the City of Palmdale has included “Project Site Sign Posting” in its public hearing notice procedures. The applicant of a proposed project scheduled for a public hearing before the City Council, Planning Commission, or Planning Manager is required to post a sign with public hearing information, which will be visible to the public right-of-way from the subject site. Late or inaccurate sign posting will cause postponement of the public hearing for the case. CASES REQUIRING SITE PLAN POSTING: Annexations Appeals Amendments, Revisions or Extensions of Time Conditional Use Permits General Plan Amendments Prezone Changes Site Plan Reviews Specific Plans Subdivisions Tentative Maps Variances Zone Changes SIGN SPECIFICATIONS: 1. SIZE: Dimensions shall be four feet by eight feet (see Figure 2. HEIGHT: Sign shall be six feet in height (see Figure 3. MATERIALS: ½ inch plywood (minimum). Sign shall be constructed with 4” x 4” supporting posts placed at a minimum depth of two feet with 2” x 4” cross supports as shown in the diagram (see Figure 4. LOCATION: A minimum of feet inside the property line in residential zones, and a minimum of one foot inside the property line in commercial and industrial zones. Shall be located in the area most visible to the public on the project site. 5. COLOR: Lavender background with black lettering (see Figure 6. LETTERING: Shall be block style. 7. LIGHTING: Shall NOT be illuminated. 8. Sign shall include ONLY the information provided by the assigned planner. If it becomes necessary to revise the information required on the sign, such as a change in the number of lots or square footage of buildings, it shall be the ---PAGE BREAK--- -11- 12/20 responsibility of the applicant to obtain approval of such revision(s) from the assigned planner. SIGN SCHEDULE: 1. Sign shall be posted a minimum of 10 days prior to the hearing date. It shall be the responsibility of the applicant to contact the Planning Division to obtain the appropriate date and time. 2. Hearing date on the sign shall be changed for Commission items which are continued or are to be heard by the City Council including, but not limited to, Zone Changes, General Plan Amendments, Specific Plans, and appealed items. Said date shall be changed a minimum of 11 days prior to the hearing. 3. Sign shall be removed within 14 days following the Planning Commission hearing date or IMMEDIATELY following final City Council action. It is recommended that the cost of sign removal be included in a sign contract with the sign company. ---PAGE BREAK--- -12- 12/20 Figure 1 Figure 2 ---PAGE BREAK--- -13- 12/20 CITY OF PALMDALE PLANNING DIVISION PUBLIC HEARING SIGN REMOVAL AUTHORIZATION Case Number(s): Assessor’s Parcel Number(s): Location (address if available): Approximately Feet N or S of (Circle) (Street Name) Approximately Feet E or W of (Circle) (Street Name) By this signature, I acknowledge that I understand the requirements for posting the subject property for public hearing and do agree to pay all costs for the removal and storage of said public hearing sign if it is not removed within 14 days of the final hearing for this/these case(s). Applicant/Agent: Date: Owner: Date: ---PAGE BREAK--- -14- 12/20 PLAN PREPARATION GUIDELINES All required plans shall be prepared accurately by a qualified individual registered civil engineer, licensed architect, licensed building designer), drawn to a standard engineering scale 1”=20’, 1”=50’, 1”=100’, 1”=200’) or architectural scale that is appropriate to the project size and able to clearly define and identify all required information. Please note that although the Planning Division does not require plans to be stamped and signed by a licensed professional, these items might be required by other divisions (i.e. Building and Safety, Engineering, etc.). Please ensure all plans include the following: A. SITE PLANS: 1. Title Block containing: a. Name, address, and phone number of the developer and/or owner. b. Name, address and phone number of person preparing plan. c. Address of project. 2. Legend containing: a. The Assessor’s Parcel Number (APN). b. Scale. c. Existing and proposed General Plan land use designation and zone. d. Date of plan preparation with revision date block. e. Statement indicating gross and net acreage (after dedications) of property. f. 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). g. Lot coverage (area of site covered by structures) expressed as percentage of site or Floor Area Ratio (if applicable). h. 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). i. 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. j. Type of building construction and occupancy. k. Include benchmarks, as applicable. ---PAGE BREAK--- -15- 12/20 3. Plot Plan Showing: a. North-arrow. 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. Also depict any existing trees that are protected by City Ordinance (PMC Chapter 14.04). 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. r. Barriers - Location and dimensions of all wheel/bumper stops and concrete headers separating vehicular areas from landscaped areas. ---PAGE BREAK--- -16- 12/20 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. Label each elevation with a directional (north, south, etc.) orientation. c. Provide color and material callouts. 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. Roof plan showing the direction of roof elements and equipment, exterior lights, vents, ducts, and other exterior mechanical utility equipment. C. COLORS AND MATERIALS: The colors and materials sample card shall be no larger than 8½” x 11” and shall contain representative samples of all external colors and materials of construction proposed for use on the project. Samples must be consistent with the information shown on the elevations. The card shall also identify the project location, name, and address, and bear a prominent label indicating the Case Number(s) it is associated with (leave space for staff to add the number). D. 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). ---PAGE BREAK--- -17- 12/20 5. Statement indicating whether or not automatic fire sprinkler systems will be used in the structure. E. CONCEPTUAL GRADING/DRAINAGE PLANS: 1. Show the proposed shape, height, and grade of the site including the direction of drainage flow, existing trees, and percent of grade (Slope Map). 2. Indicate all quantities of cut and fill and their ultimate disposition. 3. Indicate all erosion control measures including proposed detention basins and retaining walls. 4. Provide cross-sectional profiles for existing and proposed grade changes. 5. Show location of perimeter walls, if applicable, and relationship of the walls to slopes and other walls, existing and proposed. Where existing and proposed walls are shown, identify distance between wall faces and indicate grade differential, if any. F. CONCEPTUAL LANDSCAPING / IRRIGATION PLANS: 1. A rendered plan graphically identifying by symbol and notes the types of proposed plantings. Existing and proposed berms must be identified by general shape and gradient. 2. A reasonable representation of the proposed number of trees without calling out exact quantities. 3. A legend which identifies the plant material (botanical and common names) with a breakdown in percentages of the various container sizes for each tree and shrub symbol 25% 15-gallon), for each plan graphic symbol. 4. The proposed method and type of irrigation must be indicated by notes. If multiple systems of irrigation are used, clearly identify on the plan where each type of system will be used. In notes, the irrigation concept should include a proposed water management strategy. 5. Existing trees shall be shown on the plan. G. RADIUS MAP: The radius map must show the subject parcel(s) and all properties within 500 / 700 / 1,000* feet of the boundaries. Indicate the Assessor’s Parcel Number of every parcel within or touching the radius line on the map and the associated mailing label. If it is impractical to list all Assessor’s Parcel Numbers on the map, provide cross-references to the tabular mailing list. *Notification radius for the project site is calculated based on acreage of the site as follows: 20 acres or less – 500 foot radius 21 acres to 159 acres – 700 foot radius 160 acres or more – 1,000 foot radius ---PAGE BREAK--- -18- 12/20 Planning Division FIRE DEPARTMENT TRANSMITTAL LETTER This form will serve as the cover sheet for this project’s online submittal to the Los Angeles County Fire Department through the EPIC-LA permitting system. It is essential that this project be submitted to EPIC-LA as soon as possible after it is assigned to a case number, so that the review process is not delayed. Development Advisory Board comments or Conditions of Approval may be postponed if the project is not submitted in a timely manner. Applicant’s Name: Phone: Email: Project Location (address or vicinity): Assessor’s Parcel Number(s) (APN): Project Description: The instructions below outline how to submit a project to EPIC-LA. If you have questions or encounter issues during the submittal process, please reach out to Wally Collins at [EMAIL REDACTED] or (323) 890-4243. 1. Go to epical.lacounty.gov. 2. Click “Login or Register”. If you already have an account with EPIC-LA, sign in now. If you do not, please register for a new account. 3. Click “Apply”. Then, select the permit type that matches the EPIC-LA Designation listed below. 4. Follow the prompts to enter information related to your project. When you reach the Attachments screen, be sure to upload this worksheet as a “City Transmittal Letter”. 5. Email a copy of your invoice or receipt to your case planner to let them know that the item has been submitted. City Use Only Case Number: Case Planner: Email: EPIC-LA Designation: Fire – Land Development – City Requests – □ One Stop Counseling □ Lot Line Adjustment □ Tentative Parcel Map □ Conditional Use Permit □ Site Plan Review □ Zone Change □ Tentative Tract Map □ Other