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z: APPLICATION AGRICULTURAL, EXCAVATION SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT FILE NUMBER: PA- `b Excavation Characteristics Excavation Area(Acres): Fill Area(Acres): Existing Site Elevation(Average at 100'Intervals): , e Proposed Site Elevation(Average at 100'lntervals): , '7 Perimeter Elevation(Average at 100'Intervals, 100'from Prop".1.1ne): Amount of Material to be.Removed(Cubic Yards): �. Will topsoil be replaced? Yes 00 No ❑ If no,a soils report is required. Proposed method of Financial Guarantee: A Surety Bond ❑ A Trust Fund with the Community Development Department ❑ An Irrevocable Letter of Credit Approximate Start Date: (w`)S'-Za1J Approximate End Date: Hours of Operation: 7 - 3: Average Daily Truck Trips: ] Surface Transportation Assistance Act STAR trucks Will STAA type trucks,over California Legal length,be used as part of the proposed operation? A/i> Yes❑ (if yes,the applicant must provide a letter requesting designation of the proposed facility as an STAA terminal.) No ❑ AUTHORIZATION SIGNATURES OWNER, OPERATOR AND APPLICANT INFORMATION AND SIGNATURES ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. Pro a owners or owners of surface ri hts list all owners Name Address:?) Phon Y� Signat 9 Date: Name: Ad s: Phone: Signature: Date: Name: Address: Phone: Signature: Date: Name: Address: Phone: Signature: �' Date: Name: Address: Phone: Signature: Date: Note: All Legal owners of the property(s) involved in this project or their legal agents must sign the application thereby verifying that the statements contained in the application are true and correct. If a legal agent signs the application on tfalf`of the Property vw'ner w itten-consent-by- -- --_ -___ L F:%DEVSVC%Planning Application Forms% Page 4 of 15 Agricultural Excavation.doe.(Revised 02-03-10)