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(Revised 9/11) TEMPORARY USE PERMIT (TUP) APPLICATION FOR STOCKPILING Please complete all sections of this form and submit the following information to the Planning Division. Information about how to get a permit and Permit Standards are on the last page of this application. All information must be received and the fees paid before the application can be processed. The application is to be filed with the Planning Division at least sixty (60) days in advance of proposed stockpile. ALL MAPS MUST BE FOLDED BY APPLICANT TO A MAXIMUM 8½" x 11" SIZE. PLANS MAY ALSO BE PROVIDED ON 11” X 17” PAPER. Temporary Use Permit Checklist The completed Application. 1 copy of the Owner's Letter of Authorization. 2 copies of a site plan of the existing site with the location of the stockpiling area clearly indicated. 1 copy of a vicinity map at a scale clearly indicating the subject parcel and showing the existing major street patterns, adjoining projects or businesses, railroads or other significant landmarks within a minimum of one mile of the exterior boundaries of the site on 8½" by 11" paper. Site Plan Check List Applicant's name, address and telephone number Address of the site (if applicable) or Assessor's parcel number Scale North arrow Adjacent streets Site dimensions Height of stockpile Access to stockpiling area from the right-of-way Dust control method Any structures existing or proposed on the site. Fire Department approval stamp ---PAGE BREAK--- (Revised 9/11) TEMPORARY USE PERMIT APPLICATION AND REVIEW FORM FOR STOCKPILING Permit Number PLEASE PRINT Stockpiling location: (Address or Assessor's parcel number) Approximately feet N or S of (Circle) (Street Name) Approximately feet E or W of (Circle) (Street Name) Dates of stockpiling activity from: to Describe method of dust control: Describe method of screening: Describe method of erosion control: APPLICANT: Name and Email: Address: Telephone No.: ( ) Fax No.: ( ) ORGANIZATION / REPRESENTATIVE: Organization: Representative: Address: Telephone No.: ( ) Fax No.: ( ) Email: PROPERTY OWNER: Name: Address: Telephone No.: ( ) Fax No.: ( ) ---PAGE BREAK--- (Revised 9/11) OWNER AUTHORIZATION LETTER TEMPORARY USE PERMITS ONLY 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 application(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) (Printed Name) (Signature) (Date) (Address) (Telephone) ---PAGE BREAK--- (Revised 9/14) TEMPORARY USE PERMIT APPLICATION AND REVIEW FORM Permit Number OFFICE USE PLANNING DIVISION REVIEW Use permitted? Yes / No Deposit Required? Yes / No Amount Required: $ Receipt No.: USE APPROVED? Yes / No Credit Account No.: 01-2616-0097 Reason for Denial / Comments / Special Conditions: (Printed Name) (Signature) (Date) PLANNING DIVISION: BUSINESS LICENSE Deposit Required? Yes / No Amount Required: Business Permit Required? Yes / No Receipt No.: Business License App. Complete? Yes / No Date: Existing Business License No.: Date Issued: Comments: (Printed Name) (Signature) (Date) TEMPORARY USE PERMIT STANDARDS AND APPROVAL PROCESS The following standards shall be adhered to for all Temporary Uses pursuant to Ordinance No. 892 of the City of Palmdale. 1. All temporary use permits shall be processed in the following order: PLANNING DIVISION: Obtain the temporary use and business license application forms and instructions regarding the requirements. Allow a minimum of two months for processing this application. Submittal shall include a completed Temporary Use Permit application form, 1 copy of required exhibits and permits, and payment of applicable fees as listed in the application check list. For information call (661) 267-5200. ---PAGE BREAK--- (Revised 9/14) FIRE DEPT.: For any uses requiring Fire Dept. approval, applicant is required to contact the Fire Dept. and obtain an approval stamp on the proposed site plan prior to submittal of the TUP application. Planning will require 1 copy of the stamped site plan prior to issuing preliminary approval. For information call (661) 723-4455. Fire Dept. inspection may be necessary. BUSINESS LICENSE: All temporary uses will require a Business License and some uses will require a Business Permit. These documents must be displayed on site at all times during the event. NOTE: FOR ANY DEPARTMENT/DIVISION REQUIRING A FIELD INSPECTION, YOU MUST CALL FOR AND REQUEST AN INSPECTION NO LATER THAN 24 HOURS PRIOR TO INITIATING OPERATION OF THE TEMPORARY USE. PLEASE REMEMBER THAT CITY OFFICES ARE CLOSED EVERY FRIDAY. 2. The site plan shall show all items on the Site Plan Check List and be located in a zone permitting the requested activity. 3. Applicant shall provide safe and adequate roadway access including adequate vehicular sight distance at the driveway entrance/exit. 4. In no event shall any portion of the proposed use encroach onto any public rights- of-way, or be located in a way which might cause a hazard. 5. The temporary use shall not adversely affect the surrounding neighborhood by means of odor, noise, dust or other nuisances. 6. Written authorization from the property owner or their agent is required. 7. The lots used for temporary activities shall be completely cleared of all temporary structures and debris which resulted from such operation within five days after the termination of the activity. 8. A $500 bond or cash deposit, or other amount deemed necessary by the City, may be required for temporary uses to assure clean-up. The deposit shall be returned upon written request of the applicant following verification of site clean-up. Any expense incurred by the City for clean-up of the subject property shall be deducted from the deposit and the remainder returned to the applicant. 9. No stockpiling shall be permitted on undisturbed native desert vegetation without appropriate environmental review, pursuant to state law. 10. Stockpiled material shall not exceed a height of three feet, and should be evenly spread. ---PAGE BREAK--- (Revised 9/14) 11. Location of stockpiled material shall not adversely impact adjacent properties or uses through creation of windblown dust, visual appearance, or other creation of an attractive nuisance. 12. During placement or removal of stockpiled material appropriate traffic control measures shall be taken, as determined by the City Traffic/Transportation Engineer. Truck access to the stockpiling area from the adjacent right-of-way shall be approved by the Traffic/Transportation Engineer. 13. Dust control measures shall be taken during stockpiling or removal operations as deemed necessary by the Planning Manager. 14. Erosion control measures on stockpiled material shall be implemented as determined necessary by the City Landscape Architect. 15. Stockpiled material shall not contain greenwaste, trash, composted material, sludge, or biosolid material in any combinations or quantities.